J Gastroenterol Hepatol Endosc | Volume 7, Issue 1 | Research Article | Open Access

The Reciprocal Relation between Coronavirus 2019 Disease and Inactive Hepatitis B Carrier State

Mahamid M1*, Odeh Q1, Mahamid B1, Goldin E1 and Nseir W2

1Department of Gastroenterology and Liver Diseases, Hebrew University of Jerusalem, Shaare Zedek Medical
Center, Jerusalem, Israel
2Divisions of Internal Medicine, Bar-Ilan University, Safed, The Baruch Padeh Medical Center, Poriya, Israel

*Correspondance to: Mahamid Mahmud 

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Background: Coronavirus Disease 2019 (COVID-19) associated liver injury is defined as any liver damage occurring during disease progression and treatment of COVID-19 in patients with or without pre-existing liver disease. Chronic Hepatitis B Virus (HBV) infection results in high morbidity and mortality worldwide. Aims: To determine the reciprocal relation between COVID-19 infection and inactive chronic HBV state. Methods: A retrospective study conducted at Department of Gastroenterology and liver diseases, Shaare Zedek Medical Center, Jerusalem. We reviewed files of hospitalized patients with positive COVID-19 from February the first until 20th of May 2020. Hospitalized patients with COVID-19 and inactive chronic HBV infection were included in our study. The inactive Hepatitis B surface Antigen (HBsAg) carrier state was diagnosed by repeatedly normal Alanine Aminotransferase (ALT) levels, absence of Hepatitis B envelop Antigen (HBeAg), presence of anti-Hepatitis B envelop Antibody (anti-HBe AB) and undetectable or low levels of HBV Deoxyribonucleic Acid (DNA) in Polymerase Chain Reaction (PCR) -based assays. Reactivation of chronic HBV was considered upon ALT elevation and HBV DNA exceeding 2000 IU/mL, at least 10 folds increase of HBV DNA or seroconversion from anti-Hbe Ab to positive HbeAg. Results: Six subjects of 445 (1.35%) with inactive chronic HBV and COVID-19 were included in our study. The mean age was 63 ± 12 years; five of them were males (83.3%). Mean ALT was133.4 ± 22.3 U/L and mean HBV DNA was 130.66 ± 14. No case of death or fulminant hepatitis was reported, however, among patients with HBV-negative the crude mortality was 6.1%. No case of reactivation of inactive chronic HBV was detected. One of the six (16.6%) patients suffered from severe COVID-19 infection.


Hepatitis B; Coronavirus; Liver function; HBV DNA; COVID-19


Mahamid M, Odeh Q, Mahamid B, Goldin E, Nseir W. The Reciprocal Relation between Coronavirus 2019 Disease and Inactive Hepatitis B Carrier State. J Gastroenterol Hepatol Endosc. 2022; 7(1): 1108..

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