ABSTRACT
Background: Hepatitis B and C remain a global health challenge, with great morbidity and mortality. The WHO has proposed the elimination of viral hepatitis as a public health threat by 2030. In 2020, the arrival of SARS-Cov-2 pandemic stopped the screening and treatment of viral hepatitis. However, hospital admissions due to SARS-CoV-2 infection could be an opportunity to screen patients for hepatitis B and C and thus move towards viral hepatitis elimination. The aim of this study is to evaluate the results of a screening program in hospitalized COVID-19 patients. Methods: This is a transversal study conducted in two Spanish hospitals (Hospital Universitario de Burgos and Complejo Asistencial Universitario de León). All patients admitted to our centers 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. Results: In the study period, 4662 patients with COVID-19 infection 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, of whom 253 (8.75%) were anti-HBc + and 11 (0.38%) HBsAg +. From these, only 4 (0.09%) patients did not have a previous diagnosis of hepatitis B (median age 80 years, all APRI < 0.5). Seven HBsAg + patients received high dose corticosteroids;only one received prophylaxis and another one was treated with entecavir because a mild reactivation (DNA HBV 69900 IU/ml). Anti-HCV were available in 2895 (62.1%) patients, of whom 24 (0.83%) were positive. From these, 13 patients had a previous hepatitis C diagnosis: 10 patients had been treated and presented SVR, 2 achieved spontaneous cure and 1 did not receive treatment because of his age. From the 11 previously unknown anti-VHC + patients, 10 had a negative HCV RNA. Overall, only 3 (0.1%) patients tested RNA HCV positive. However, none received HCV treatment (2 older than 90 years, 1 died from COVID-19). Conclusion: Screening of hepatitis B and C infection in hospitalized COVID-19 patients seems to be an unsuccessful tool in our region. The low prevalence of infection after antiviral treatments, the high age of our population and the difficulties for the application of the protocol in the context of the pandemic limit the detection of potential HCV candidates for treatment. HBV screening in this context should be aimed to prevent reactivation under immunosuppressive treatments.