Servicio de Aparato Digestivo, Hospital Universitario de Burgos, Burgos, España.
Servicio de Aparato Digestivo, Hospital Universitario de Burgos, Burgos, España.
Gastroenterol Hepatol. 2022 Apr;45(4):256-264. doi: 10.1016/j.gastrohep.2021.09.002. Epub 2021 Sep 9.
To evaluate the results of a hepatitis B and C screening program in hospitalized COVID-19 patients.
Transversal prospective study conducted in two Spanish hospitals. Patients admitted from March 1st to December 31st 2020 with a diagnosis of COVID-19 were tested for markers of hepatitis B (HBsAg, anti-HBc) and C (anti-HCV, HCV RNA) infection.
In this period, 4662 patients with COVID-19 were admitted to our centers: 56.3% were male, median age was 76 (0-104) years. Data regarding HBV infection was available in 2915 (62.5%) patients; 253 (8.75%) were anti-HBc+ and 11 (0.38%) HBsAg+. From these, 4 patients did not have a previous diagnosis of hepatitis B, 7 received corticosteroids and one received prophylaxis. There was one HBV reactivation. Anti-HCV was available in 2895 (62%) patients; 24 (0.83%) were positive. From these, 13 patients had a previous hepatitis C diagnosis: 10 patients had been treated with SVR, one achieved spontaneous cure and 2 did not receive treatment. From the 11 previously unknown anti-VHC+patients, 10 had a negative HCV RNA. Overall, only 3 (0.10%) patients tested RNA HCV+. However, none received HCV treatment (2 older than 90 years with comorbidities, 1 died from COVID-19).
Screening of hepatitis C infection in hospitalized COVID-19 patients seems less useful than expected. The low prevalence of active infection after antiviral treatments and the high age of our population limit the detection of potential candidates for treatment. HBV screening should be aimed to prevent reactivation under immunosuppressive treatments.
评估住院 COVID-19 患者乙型肝炎和丙型肝炎筛查计划的结果。
在西班牙的两家医院进行横断面前瞻性研究。2020 年 3 月 1 日至 12 月 31 日期间，对诊断为 COVID-19 的住院患者进行乙型肝炎（HBsAg、抗-HBc）和丙型肝炎（抗-HCV、HCV RNA）感染标志物检测。
在此期间，我们中心共收治了 4662 例 COVID-19 患者：56.3%为男性，中位年龄为 76（0-104）岁。有 2915（62.5%）例患者的乙型肝炎感染数据可用；253 例（8.75%）为抗-HBc+，11 例（0.38%）为 HBsAg+。其中，4 例患者此前无乙型肝炎诊断，7 例患者接受了皮质类固醇治疗，1 例患者接受了预防治疗。有 1 例发生乙型肝炎再激活。有 2895（62%）例患者的抗-HCV 数据可用；24 例（0.83%）为阳性。其中，13 例患者此前患有丙型肝炎：10 例患者获得了 SVR，1 例患者自发痊愈，2 例患者未接受治疗。在 11 例之前未知的抗-VHC+患者中，有 10 例 HCV RNA 为阴性。总体而言，仅 3 例（0.10%）患者的 HCV RNA 检测呈阳性。然而，他们均未接受 HCV 治疗（2 例患者年龄均大于 90 岁且合并症较多，1 例患者死于 COVID-19）。
与预期相比，住院 COVID-19 患者丙型肝炎感染的筛查似乎效果不佳。抗病毒治疗后活动性感染的低患病率和我们人群的高年龄限制了对潜在治疗候选者的检测。乙型肝炎筛查应旨在预防免疫抑制治疗下的再激活。
