Hepatitis B reactivation after COVID-19: just a coincidence or a causal relationship?

Abstract

A 48 year-old man was evaluated because of a sudden raise in his liver function tests. He had a prior history of an acute hepatitis B infection, which spontaneously resolved in 2015 and a recent COVID-19 infection. As he only developed a mild disease, he did not receive steroids or convalescent plasma, or any other drugs. Seven weeks after having acquired the infection, he presented an acute hepatitis. Every known etiological factor was discarded. New serological status for hepatitis B was evaluated, and we discovered a sero-reversion. This situation could often be seen after immunosuppressive treatments, but our patient receive none of them. We started Entecavir and a rapid negativization of his viral load was observed as well as a normalization of his liver tests. If this reactivation was a consequence of COVID-19 or not is still not clear for us, but we believe that this case could raise awareness among physicians.