Interaction between hepatitis B virus and SARS-CoV-2 infections

Abstract

Coronavirus disease 2019 (COVID-19) has become a global pandemic and garnered international attention. The causative pathogen of COVID-19 is severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel, highly contagious coronavirus. Numerous studies have reported that liver injury is quite common in patients with COVID-19. Hepatitis B has a worldwide distribution as well as in China. At present, hepatitis B virus (HBV) remains a leading cause of cirrhosis, liver failure, and hepatocellular carcinoma. Because both viruses challenge liver physiology, it raises questions as to how coinfection with HBV and SARS-CoV-2 affect disease progression and mortality. Is there an increased risk of COVID-19 in patients with HBV infection? In this review, we summarize the current reports of SARS-CoV-2 and HBV coinfection and elaborate the interaction of the two diseases. The emphasis was placed on evaluating the impact of HBV infection on disease severity and clinical outcomes in patients with COVID-19 and discussing the potential mechanism behind this effect.

Keywords: COVID-19; Coinfection; Hepatitis B virus; Immune exhaustion; Liver injury; SARS-CoV-2.

Figure 1

Comparison of clinical outcomes of coronavirus disease 2019 in hepatitis B virus and non-hepatitis B virus groups. A: Discharge rate; B: Mortality rate; C: Proportion of severe/critically ill patients. The data were collected from different clinical studies. COVID-19: Coronavirus disease 2019; HBV: Hepatitis B virus.

Figure 2

Graphical abstract. COVID-19: Coronavirus disease 2019; HBV: Hepatitis B virus; IFN: Interferon; IL: Interleukin; RdRp: RNA-dependent RNA polymerase; SARS-CoV-2: Severe acute respiratory syndrome coronavirus 2; TNF-α: Tumor necrosis factor-alpha.