COVID-19 Hastalarında HBV, HCV, HIV Prevalansı ve Klinik Seyre Etkisi

Öz

Amaç: COVID-19, hepatit B gibi viral enfeksiyonlarda hepatik alevlenmeyle seyredebilir. COVID-19 hastalarında HBV, HCV, HIV prevalansının ve klinik seyrinin araştırılması amaçlanmıştır. Materyal ve Metot: COVID-19 nedeniyle yatarak takip edilen, hepatit ve HIV serolojik tetkikleri istenen hastalar çalışmaya dahil edildi. Hastaların demografik verileri; HBV, HCV, HIV serolojileri; ALT, AST sonuçları kaydedildi. Bulgular: Çalışmaya alınan 226 hastanın 118’i (%52) erkek, 108’i (%48) kadındı, yaş ortalaması 63,47±16,09 yıldı. HBsAg pozitifliği altı (%3), izole Anti-HBcIgG pozitifliği altı (%3), Anti-HCV pozitifliği yedi (%3) hastada mevcuttu. Anti-HIV pozitifliği saptanmadı. HBsAg pozitif hastaların ikisinde HBV-DNA negatif, dördünde pozitifti. Anti-HCV pozitif hastalarda HCV-RNA negatifti. İstatistiksel olarak anlamlı olmasa da HBsAg pozitif hastaların yaş ortancası daha düşük; ALT, AST ortancası daha yüksekti. Ancak yatış süresi ile yoğun bakıma devir ve taburcu olma durumu tüm gruplarda benzerdi. Sonuç: HBsAg pozitif hasta grubunda karaciğer enzimlerinin yüksek olduğu saptanmıştır. Bu nedenle COVID-19’un HBsAg pozitif hastalarda hepatik alevlenmeye sebep olabileceği düşünülmüştür.

Anahtar Kelimeler

• COVID-19
• HBV
• HCV
• HIV

Prevalence of HBV, HCV, HIV and Effect on Clinical Course in COVID-19 Patients

Abstract

Objective: COVID-19 may progress with hepatic exacerbation in viral infections such as hepatitis B. It was aimed to investigate the prevalence and clinical course of HBV, HCV, and HIV in COVID-19 patients. Materials and Methods: Patients who were hospitalized due to COVID-19 and requested hepatitis and HIV serological tests were included in the study. Demographic data, HBV, HCV, HIV serologies, ALT, and AST results of patients were recorded. Results: Out of 226 patients included in the study, 118(52%) were male, 108(48%) were female, and the average age was 63.47±16.09 years. HBsAg positivity was found in six (3%), isolated Anti-HBcIgG positivity in six (3%), and Anti-HCV positivity in seven (3%) patients. Anti-HIV positivity wasn’t detected. In two HBsAg-positive patients, HBV-DNA was negative, and in four, it was positive. In anti-HCV-positive patients, HCV-RNA was negative. Although not statistically significant, the median age of HBsAg-positive patients was lower, and the median ALT and AST were higher. However, the length of hospital stay, transfer rate to the intensive care unit, and discharge status were similar in all groups. Conclusion: Liver enzymes were high in the HBsAg-positive patient group. Therefore, it was considered that COVID-19 may cause hepatic exacerbation in HBsAg-positive patients.

Keywords

• COVID-19
• HBV
• HCV
• HIV

References

1. 1. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497-506.
2. 2. Dong L, Hu S, Gao J. Discovering drugs to treat coronavirus disease 2019 (COVID-19). Drug Discov Ther. 2020;14(1):58-60.
3. 3. Téllez L, Martín Mateos RM. COVID-19 and liver disease: An update. Gastroenterología y Hepatología. 2020;43(8):472-480.
4. 4. Zhang C, Shi L, Wang FS. Liver injury in COVID-19: Management and challenges. Lancet Gastroenterol Hepatol. 2020;5(5):428-430.
5. 5. Docherty AB, Harrison EM, Green CA, et al. Features of 20 133 UK patients in hospital with COVID-19 using the ISARIC WHO clinical characterisation protocol: Prospective observational cohort study. BMJ. 2020;369:m1985.
6. 6. Zhang H, Kang Z, Gong H, et al. Digestive system is a potential route of COVID19: An analysis of single-cell coexpression pattern of key proteins in viral entry process. Gut. 2020;69(6):1010-1018.
7. 7. Dayan S. Hepatitis C virus infection. In: Infectious Diseases Diagnosis and Treatment Manual. 1st ed. Ankara, Hippocratic Publishing House; 2022:11-16.
8. 8. Dayan S. HIV/AIDS. In: Infectious Diseases Diagnosis and Treatment Manual. 1st ed. Ankara, Hippocratic Publishing House; 2022:19-35.

9. 9. Moroğlu Ç, Tülek N, Aktepe E, et al. Causes of acute exacerbation of chronic hepatitis B infection: A report of case series. Viral Hepatitis Journal. 2015;21(2):48-51.
10. 10. T.C. Ministry of Health. COVID-19 Information Platform. COVID-19 (SARS-CoV-2 Infection) General Information, Epidemiology and Diagnosis 2020. https://covid19.saglik.gov.tr/TR-66337/genel-bilgiler-epidemioloji-ve-tani.html. Accessed June 6, 2022.
11. 11. Bourgonje AR, Abdulle AE, Timens W, et al. Angiotensin-converting enzyme 2 (ACE2), SARS-CoV-2 and the pathophysiology of coronavirus disease 2019 (COVID-19). J Pathol. 2020;251:228-248.
12. 12. Bayrak M, Çadırcı K. A case of acute hepatitis associated with COVID-19 in a geriatric patient. J Med Palliat Care. 2021;2(3):102-104.
13. 13. Tian S, Xiong Y, Liu H, Niu L, Guo J, Liao M, et al. Pathological study of the 2019 novel coronavirus disease (COVID-19) through postmortem core biopsies. Modern Pathology. 2020;33:1007-1014.
14. 14. Wang Y, Liu S, Liu H, et al. SARS-CoV-2 infection of the liver directly contributes to hepatic impairment in patients with COVID-19. J hepatol. 2020;73(4):807-816.
15. 15. Xu L, Liu J, Lu M, Yang D, Zheng X. Liver injury during highly pathogenic human coronavirus infections. Liver Int. 2020;40(5):998-1004.
16. 16. Phipps MM, Barraza LH, LaSota ED, et al. Acute liver injury in COVID‐19: Prevalence and association with clinical outcomes in a large US cohort. Hepatology. 2020;72(3):807-817.
17. 17. Kunutsor SK, Laukkanen JA. Hepatic manifestations and complications of COVID-19: A systematic review and metanalysis. J Infect. 2020;81(3):e72-e74.
18. 18. T.C. Ministry of Health, General Directorate of Public Health. 2018-Ankara. Türkiye Viral Hepatitis Prevention and Control Program 2018-2023. https://hsgm.saglik.gov.tr/tr/bulasicihastaliklar-haberler/turkiye-viral-hepatit-onleme-ve-kontrol-programi.html. Accessed June 10, 2022.
19. 19. Reddy KR. SARS‐CoV‐2 and the liver: Considerations in hepatitis B and hepatitis C infections. Clin Liver Dis. 2020;15(5):191-194.
20. 20. Richardson S, Hirsch JS, Narasimhan M, et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID‐19 in the New York City area. JAMA. 2020;323(20):2052-2059.
21. 21. Jin X, Lian JS, Hu JH, et al. Epidemiological, clinical and virological characteristics of 74 cases of coronavirus-infected disease 2019 (COVID-19) with gastrointestinal symptoms. Gut. 2020;69(6):1002-1009.
22. 22. Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Eng J Med. 2020;382:1708‐1720.
23. 23. Chen X, Jiang Q, Ma Z, et al. Clinical characteristics of hospitalized patients with SARS‐CoV‐2 and hepatitis B virus co‐infection. Virol Sin. 2020;35(6):842-845.
24. 24. Zha L, Li S, Pan L, et al. Corticosteroid treatment of patients with coronavirus disease 2019 (COVID-19). Med J Aust. 2020;212(9):416-420.
25. 25. Blanco JL, Ambrosioni J, Garcia F, et al. COVID‐19 in patients with HIV: clinical case series. Lancet HIV. 2020;7(5):e314‐e316.
26. 26. Altuntas Aydin O, Kumbasar Karaosmanoglu H, Kart Yasar K. HIV/SARS‐CoV‐2 co‐infected patients in Istanbul, Turkey. J Med Virol. 2020;92(11):2288-2290.