Peg-IFNα reduces clinical severity but cannot prevent COVID-19 infection in chronic hepatitis B patients: a cohort study in China

INTRODUCTION: SARS-CoV-2/HBV coinfections are increasingly common as SARS-CoV-2 continues to evolve. The interferon (IFN) therapy for HBV infection might also have antiviral effects against SARS-CoV-2. To understand the effects of IFN on SARS-CoV-2 infection, we compared the clinical characteristics between IFN-treated chronic hepatitis B (CHB) patients and nucleo(s)tide analogs (NAs)-treated CHB patients during their SARS-CoV-2 infection. METHODS: Our cohort study enrolled patients with primary SARS-CoV-2 infections among IFN-treated and NAs-treated CHB patients during the Omicron wave in Shanghai, China, from December 7 2022 to January 23 2023. Clinical characteristics and self-reported acute symptoms during SARS-CoV-2 infection were collected by telephone questionnaire in January 2023. RESULTS: The four most common symptoms were fever, fatigue, cough and sore throat among all enrolled participants, regardless of their treatment. Interestingly, Pegylated interferon-alpha (Peg-IFNα) treated CHB patients had a significantly higher proportion of asymptomatic infection than NAs-treated CHB patients (14.53% vs. 2.70%, p = 0.002). Additionally, IFN-treated CHB patients had significantly lower duration of fever (p = 0.018), less usage of antipyretics (p < 0.0001), less occurrence of muscle and/or joint pain (p < 0.0001), less occurrence of headache (p < 0.0001) and less occurrence of runny nose (p < 0.0001) compared to NAs-treated CHB patients. CONCLUSION: In this real-world cohort of CHB patients infected with SARS-CoV-2 during the Omicron wave, Peg-IFNα treatment was associated with milder self-reported acute clinical manifestations, including a higher proportion of asymptomatic infection and reduced occurrence of several common symptoms.