Background/Aims We measured the association between underlying chronic hepatitis B (CHB) and antiviral use with infection rates among patients who underwent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing. Methods In total, 204,418 patients who were tested for SARS-CoV-2 between January and June 2020 were included. For each case patient (n = 7,723) with a positive SARS-CoV-2 test, random controls (n = 46,231) were selected from the target population who had been exposed to someone with coronavirus disease 2019 (COVID-19) but had a negative SARS-CoV-2 test result. We merged claim-based data from the Korean National Health Insurance Service database collected. Primary endpoints were SARS-CoV-2 infection and severe clinical outcomes of COVID-19. Results The proportion of underlying CHB was lower in COVID-19 positive patients (n = 267, 3.5%) than in COVID-19 negative controls (n = 2482, 5.4%). Underlying CHB was associated with a lower SARS-CoV-2 positivity rate, after adjusting for comorbidities (adjusted odds ratio [aOR] 0.65; 95% confidence interval [CI], 0.57–0.74). Among patients with confirmed COVID-19, underlying CHB tended to confer a 66% greater risk of severe clinical outcomes of COVID-19, although this value was statistically insignificant. Antiviral treatment including tenofovir and entecavir was associated with a reduced SARS-CoV-2 positivity rate (aOR 0.49; 95% CI, 0.37–0.66), while treatment was not associated with severe clinical outcomes of COVID-19. Conclusions Underlying CHB and antiviral agents including tenofovir decreased susceptibility to SARS-CoV-2 infection. HBV coinfection did not increase the risk of disease severity or lead to a worse prognosis in COVID-19.
【초록키워드】 COVID-19, Treatment, coronavirus disease, SARS-CoV-2, Coronavirus disease 2019, coronavirus, Antiviral, SARS-COV-2 infection, susceptibility, disease severity, Comorbidities, Comorbidity, risk, Antiviral treatment, severe acute respiratory syndrome Coronavirus, database, Clinical outcome, HBV, Coinfection, Antiviral agents, Patient, Control, infection rate, respiratory, antiviral agent, Korean, association, Chronic Hepatitis B, lead, with infection, chronic hepatitis, test result, Health Insurance, tenofovir, target population, National Health Insurance, entecavir, insurance, acute respiratory syndrome, adjusted odds ratio, Endpoint, 95% CI, acute respiratory syndrome coronavirus, acute respiratory syndrome coronavirus 2, 95% confidence interval, primary endpoints, negative controls, infection rates, worse prognosis, positive patients, SARS-CoV-2 positivity, random, positive, SARS-CoV-2 test, service, Result, greater, selected, tested, collected, proportion, reduced, statistically, CHB, COVID-19 negative, COVID-19 positive patient, 【제목키워드】 COVID-19, Infection, cohort study, Korean,