Although coronavirus disease 2019 (COVID-19), a pandemic is caused by infection in the respiratory tract. Extrapulmonary involvement including dysregulation of the immune system and hepatic injury is a common feature in these patients. Owing to the high prevalence of hepatitis B virus (HBV) infection in China, the country where it first emerged, the authors of  the study determined the effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and HBV coinfection in patients.

The study included blood samples of 50 SARS-CoV-2 and HBV coinfected patients, 56 SARS-CoV-2 mono-infected patients, 57 HBeAg-negative chronic HBV patient controls and 57 healthy controls. Investigations included complete blood count and serum biochemistry panels including markers indicative of liver functions. Cytokines including IFN-γ, TNF-α, IL-2, IL-4, IL-6 and IL-10 were examined and T cell, B cell and NK cell counts were analysed using flow cytometry.

The outcome of the study showed that SARS-CoV-2 and HBV coinfection did not significantly affect the outcome of the COVID-19. On the contrary, SARS-CoV-2 and HBV coinfected patients demonstrated more severe monocytopenia and thrombocytopenia along with impaired hepatic function in albumin production and lipid metabolism. Moreover, majority of disruption could be normalized after recovery from COVID-19.

The study concluded that although chronic HBV infection do not predispose COVID-19 patients to more severe consequences, coinfection of SARS-CoV-2 and HBV creates a greater extent of dysregulation of host functions at the onset of COVID-19. Therefore, management of SARS-CoV-2 and HBV coinfected patients need more vigilance.

Source: Liu R, Zhao L, Cheng X, Han H, Li C, Li D, Liu A, Gao G, Zhou F, Liu F, Jiang Y, Zhu C, Xia Y. Clinical characteristics of COVID-19 patients with hepatitis B virus infection - a retrospective study. Liver Int. 2021 Apr;41(4):720-730.