Alleviated symptoms of SARS‐CoV‐2 Omicron variant infection in chronic hepatitis B patients with immune control

Abstract

The impact of hepatitis B virus (HBV) infection on the progression of coronavirus disease 2019 (COVID‐19) disease remains controversial. We aimed to investigate whether pre‐existing chronic HBV (CHB) infection and therapy with anti‐HBV nucleos(t)ide analogs (NAs) influence the clinical presentation of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) Omicron variant infection. In this study, clinical information was collected via a questionnaire from patients with COVID‐19, and their clinical symptoms were quantitatively assessed for comparative analyses. Additionally, hepatitis B‐related laboratory data were collected for CHB patients. Propensity score matching (PSM) was used to minimize confounding biases. A total of 785 patients with COVID‐19 were included in the cohort, of which 387 were identified as being infected with CHB infection and they were categorized as being in the immune control or clearance phase. After PSM, the CHB group (n = 222) had a shorter duration of fever and disease course, milder clinical symptoms, and lower incidence of pneumonia than the non‐CHB group (n = 222) after Omicron variant infection (p < 0.05). After the adjustment of confounding factors, CHB patients showed a lower risk of prolonged fever, severe clinical symptoms, and pneumonia (p < 0.05). However, there were no statistically significant differences in the clinical symptoms and incidence of pneumonia between CHB patients who received and did not receive NAs, or CHB patients who received tenofovir disoproxil fumarate and entecavir (p > 0.05). In conclusion, our findings suggest that the crosstalk of anti‐HBV immunity may contribute to the alleviated symptoms of SARS‐CoV‐2 Omicron variants infection in the CHB patients, independent of anti‐HBV NA therapy.

Clinical characteristics and immunogenicity after Omicron breakthrough infection in patients with chronic hepatitis B infection: A longitudinal observational study

“…This is similar to that reported in previous studies on the general population, 24,25 and further confirms the weak protection of WT vaccine against Omicron infection. After BTI, the clinical symptoms of COVID‐19 were mild to moderate, which was similar to previous observations 13,25,26 . This may be attributed to the low virulence of Omicron or the protection against severe illness of vaccines.…”

“…After BTI, the clinical symptoms of COVID-19 were mild to moderate, which was similar to previous observations. 13,25,26 This may be attributed to the low virulence of Omicron or the protection against severe illness of vaccines. No exacerbation of liver disease occurred in patients with CHB after BTI; however, compared to that in HCs, our results showed a higher proportion of moderate COVID-19 in patients with CHB.…”

“…Patients with chronic liver disease have a higher risk of infection and worse outcomes from COVID‐19 than do individuals without liver disease 10,11 . However, clinical studies have demonstrated that chronic hepatitis B virus infection (CHB) does not necessarily predispose patients with COVID‐19 to more severe outcomes 12,13 . These controversial conclusions suggest the need for further study of the interaction between HBV and SARS‐CoV‐2 co‐infection.…”

“…10,11 However, clinical studies have demonstrated that chronic hepatitis B virus infection (CHB) does not necessarily predispose patients with COVID-19 to more severe outcomes. 12,13 These controversial conclusions suggest the need for further study of the interaction between HBV and SARS-CoV-2 co-infection. Our previous studies revealed that antibody response to primary inactivated vaccines was lower in patients with CHB than in healthy controls (HCs); booster vaccination could improve the situation.…”