Published in:
Open Access
03-02-2023 | Hepatitis B | Original Article
Tenofovir Disoproxil Fumarate Reduces the Severity of COVID-19 in Patients with Chronic Hepatitis B
Authors:
Beatriz Mateos-Muñoz, María Buti, Inmaculada Fernández Vázquez, Marta Hernández Conde, Vanesa Bernal-Monterde, Fernando Díaz-Fontenla, Rosa María Morillas, Luisa García-Buey, Ester Badía, Mireia Miquel, Alberto Amador-Navarrete, Sergio Rodríguez-Tajes, Lucía Ramos-Merino, Antonio Madejón, Montserrat García-Retortillo, Juan Ignacio Arenas, Joaquín Cabezas, Jesús Manuel González Santiago, Conrado Fernández-Rodríguez, Patricia Cordero, Moisés Diago, Antonio Mancebo, Alberto Pardo, Manuel Rodríguez, Elena Hoyas, Jose Javier Moreno, Juan Turnes, Miguel Ángel Simón, Cristina Marcos-Fosch, Jose Luis Calleja, Rafael Bañares, Sabela Lens, Javier Garcia-Samaniego, Javier Crespo, Manuel Romero-Gomez, Francisco Gea, Enrique Rodríguez de Santiago, Santiago Moreno, Agustin Albillos
Published in:
Digestive Diseases and Sciences
|
Issue 6/2023
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Abstract
Background and Aims
HIV-positive patients on tenofovir hydroxyl fumarate (TDF)/emtricitabine have a lower risk of COVID-19 and hospitalization than those given other treatments. Our aim was to analyze the severity of COVID-19 in patients with chronic hepatitis B (CHB) on TDF or entecavir (ETV).
Methods
Spanish hospital databases (n = 28) including information regarding adult CHB patients on TDF or ETV for the period February 1st to November 30th 2020 were searched for COVID-19, defined as a positive SARS-CoV-2 polymerase chain reaction, and for severe COVID-19.
Results
Of 4736 patients, 117 had COVID-19 (2.5%), 67 on TDF and 50 on ETV. Compared to patients on TDF, those on ETV showed (p < 0.05) greater rates of obesity, diabetes, ischemic cardiopathy, and hypertension. COVID-19 incidence was similar in both groups (2.3 vs. 2.6%). Compared to TDF, patients on ETV more often (p < 0.01) had severe COVID-19 (36 vs. 6%), required intensive care unit (ICU) (10% vs. 0) or ventilatory support (20 vs. 3%), were hospitalized for longer (10.8 ± 19 vs. 3.1 ± 7 days) or died (10 vs. 1.5%, p = 0.08). In an IPTW propensity score analysis adjusted for age, sex, obesity, comorbidities, and fibrosis stage, TDF was associated with a sixfold reduction in severe COVID-19 risk (adjusted-IPTW-OR 0.17, 95%CI 0.04–0.67, p = 0.01).
Conclusion
Compared to ETV, TDF seems to play a protective role in CHB patients with SARS-CoV-2 whereby the risk of severe COVID-19 is lowered.