Journal Article

Autoimmune hepatitis after COVID-19 vaccination

Zheng, Han, Xu, Yiyao, Sang, Xinting, Zhang, Ting, Lu, Xin

2022

Overview

Vaccination is one of the most vigorous ways to intervene in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. Cases of autoimmune hepatitis (AIH) after coronavirus disease (COVID-19) vaccination have been increasingly reported. Twenty-seven cases of AIH are summarized in this study, providing emerging evidence of autoimmune reactions in response to various COVID-19 vaccines, including in patients with special disease backgrounds such as primary sclerosing cholangitis (PSC), liver transplantation, and previous hepatitis C virus (HCV) treatment. Molecular mimicry, adjuvants, epitope spreading, bystander activation, X chromosome, and sceptical hepatotropism of SARS-CoV-2 may account for, to some extent, such autoimmune phenomena. Immunosuppressive corticosteroids perform well with or without azathioprine in such post-COVID-19-vaccination AIH. However, determination of the exact mechanism and establishment of causality require further confirmation.

• Publisher: Frontiers Media SA,Frontiers Media S.A
• Subject: Adjuvants / Anorexia / Antigens / Autoimmune diseases / autoimmune hepatitis (AIH) / Azathioprine / Biopsy / Cholangitis / Coronaviruses / Corticosteroids / COVID-19 / COVID-19 - prevention & control / COVID-19 vaccines / COVID-19 Vaccines - adverse effects / Disease transmission / Enzymes / Epitopes / Females / Fever / Hepatitis C / Hepatitis, Autoimmune - etiology / Humans / Immunology / Infections / Jaundice / Liver / Liver transplantation / Mimicry / Postpartum period / Proteins / Pruritus / SARS-CoV-2 / Severe acute respiratory syndrome coronavirus 2 / vaccination / Vaccination - adverse effects