ABSTRACT
BACKGROUND AND AIMS: HIV-positive patients on tenofovir hydroxyl fumarate (TDF)/emtricitabine have a lower risk of COVID-19 and hospitalization than those given other treatments. Our aim was to analyze the severity of COVID-19 in patients with chronic hepatitis B (CHB) on TDF or entecavir (ETV). METHODS: Spanish hospital databases (n = 28) including information regarding adult CHB patients on TDF or ETV for the period February 1st to November 30th 2020 were searched for COVID-19, defined as a positive SARS-CoV-2 polymerase chain reaction, and for severe COVID-19. RESULTS: Of 4736 patients, 117 had COVID-19 (2.5%), 67 on TDF and 50 on ETV. Compared to patients on TDF, those on ETV showed (p < 0.05) greater rates of obesity, diabetes, ischemic cardiopathy, and hypertension. COVID-19 incidence was similar in both groups (2.3 vs. 2.6%). Compared to TDF, patients on ETV more often (p < 0.01) had severe COVID-19 (36 vs. 6%), required intensive care unit (ICU) (10% vs. 0) or ventilatory support (20 vs. 3%), were hospitalized for longer (10.8 ± 19 vs. 3.1 ± 7 days) or died (10 vs. 1.5%, p = 0.08). In an IPTW propensity score analysis adjusted for age, sex, obesity, comorbidities, and fibrosis stage, TDF was associated with a sixfold reduction in severe COVID-19 risk (adjusted-IPTW-OR 0.17, 95%CI 0.04-0.67, p = 0.01). CONCLUSION: Compared to ETV, TDF seems to play a protective role in CHB patients with SARS-CoV-2 whereby the risk of severe COVID-19 is lowered.
Subject(s)
COVID-19 , Hepatitis B, Chronic , Adult , Humans , Tenofovir/therapeutic use , Antiviral Agents/therapeutic use , Hepatitis B, Chronic/complications , Hepatitis B, Chronic/drug therapy , Treatment Outcome , COVID-19/complications , SARS-CoV-2 , Retrospective StudiesABSTRACT
Fumar es el factor prevenible más importante de entre los asociados con enfermedad y muerte en los países desarrollados, existiendo evidencia de su relación con la aparición de distintos tipos de cánceres, por lo que todos los planes de prevención de esta enfermedad incluyen la reducción del consumo de tabaco como uno de sus objetivos centrales. Según la evidencia disponible, los procedimientos de elección para el tratamiento del tabaquismo son los que utilizan tratamientos psicológicos de tipo conductual de amplio espectro, combinados o no con intervenciones farmacológicas. En este artículo se presenta el fundamento teórico, los ingredientes terapéuticos y una breve guía de sesiones del Programa para Dejar de Fumar del Ayuntamiento de Madrid, programa multicomponente en formato grupal que se ejecuta en los 15 centros municipales Madrid Salud. Se presentan sus resultados principales y se concluye con una argumentación a favor del tratamiento psicológico, frente al reduccionismo biologicista imperante fuertemente condicionado por intereses de la industria farmacéutica
Smoking is the most important prevention factor related to disease and death in developed countries. There is scientifi c evidence of its relation with different types of cancer so all prevention strategies in this disease include tobacco consumption reduction as a principal objective. According to the evidence available, election procedures in smoking treatment are those which use psychological treatment combined or not with pharmacological treatment. This paper presents a theoretical foundation, therapeutic ingredients and a brief sessions guide from the Programa para Dejar de Fumar del Ayuntamiento de Madrid, a multicomponent group program carried out in 15 municipal centres Madrid Salud. Main results are presented and the paper concludes with an argument in favour of the psychological treatment in front of the prevailing biological reductionism hardly associated with pharmaceutical industry interests
