학술논문
Tenofovir Disoproxil Fumarate Reduces the Severity of COVID-19 in Patients with Chronic Hepatitis B.
Document Type
Article
Author
Mateos-Muñoz, Beatriz; Buti, María; Vázquez, Inmaculada Fernández; Conde, Marta Hernández; Bernal-Monterde, Vanesa; Díaz-Fontenla, Fernando; Morillas, Rosa María; García-Buey, Luisa; Badía, Ester; Miquel, Mireia; Amador-Navarrete, Alberto; Rodríguez-Tajes, Sergio; Ramos-Merino, Lucía; Madejón, Antonio; García-Retortillo, Montserrat; Arenas, Juan Ignacio; Cabezas, Joaquín; Santiago, Jesús Manuel González; Fernández-Rodríguez, Conrado; Cordero, Patricia
Source
Subject
*CHRONIC hepatitis B
*COVID-19
*TENOFOVIR
*INTENSIVE care units
*POLYMERASE chain reaction
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Language
ISSN
0163-2116
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. [ABSTRACT FROM AUTHOR]