Are Hep B patients on antiviral therapy less likely to catch covid?

I have seen in my practice that my patients on antiviral therapies are not contracting covid, wanted to know if other doctors or patients also experiencing the same? This seems to be a good hypothesis to test too. Also, I have seen trials using tenofovir and other hepb antivirals for curing covid.

Dr Sumaiya Petiwala
Registered Dietitian (RD)
Consulting Dietitian and Medical Nutritionist
General Physician (BUMS)

Dear Sumaiya,

There shouldn’t be any reason why Hep B antivirals would affect SARS-CoV2. Reverse transcriptase inhibitors (entecavir, tenofovir, adefovir, lamivudine, etc.) work by targeting the virus protein that converts RNA to DNA (which is necessary for HBV to produce more virus). But SARS-CoV2 does not do this (it replicates by converting RNA to more RNA, no DNA step), so these drugs won’t help.

Indeed, Hep B drugs have been tested and do nothing against the virus: https://aac.asm.org/content/65/1/e01652-20. The paper also looks at HCV and HIV drugs, which show similarly poor effects.

I also don’t think it has been the experience of other centres that Hep B patients have fewer cases of COVID19. Any @HealthExperts want to weigh in here?

Cheers,
Thomas

Hello Dr Sumaiya,
A lot of my very close family member including me and my mother are chronically infected with HEP B and are on antiviral medications for few years now.

  • Recently my father contracted Covid-19, followed by my 2 sisters but my mother didn’t. We conducted multiple RT- PCR tests to confirm.

  • My maternal aunt’s husband contracted Covid-19 and got pretty serious and has to be hospitalized but my aunt who is on tenofovir remained Covid-19 negative (confirmed by an RT-PCR test).

  • I’m also on Entecavir and never contracted Covid-19, although my case might not be relevant since I never came in contact with anyone who is Covid-19 positive (at least that I know of).

I’ve noticed few other similar events too.
I know these are only anecdotes but there seems to be a correlation between mentioned antivirals and Covid-19 and therefore the topic should be further explored by scientific community.