Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 7, 2021; 27(9): 782-793
Published online Mar 7, 2021. doi: 10.3748/wjg.v27.i9.782
Interaction between hepatitis B virus and SARS-CoV-2 infections
Tian-Dan Xiang, Xin Zheng
Tian-Dan Xiang, Xin Zheng, Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
Author contributions: Zheng X contributed to the conception and design of the work and revised the manuscript; Xiang TD performed the literature review and drafted the manuscript.
Conflict-of-interest statement: Authors declare no conflict of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Xin Zheng, MD, PhD, Professor, Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jiefang Avenue, Wuhan 430022, Hubei Province, China.
Received: December 8, 2020
Peer-review started: December 8, 2020
First decision: December 31, 2020
Revised: January 11, 2021
Accepted: February 1, 2021
Article in press: February 1, 2021
Published online: March 7, 2021

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, Hepatitis B virus, Liver injury, SARS-CoV-2, Coinfection, Immune exhaustion

Core Tip: Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has become a global public health crisis. Liver impairment is frequent in COVID-19 regardless of whether it is combined with hepatitis B virus (HBV) infection. Currently, there is no evidence to suggest that HBV increases susceptibility to SARS-CoV-2. HBV and SARS-CoV-2 coinfection does not increase the risk of severity and outcome of COVID-19. Nucleoside analogs are recommended due to the risk of HBV reactivation in COVID-19.