Letter to the editor: Exacerbation of autoimmune hepatitis after COVID‐19 vaccination

Gui, Honglian; Sheng, Zhonghua; Xin, Haiguang; Xie, Qing

doi:10.1002/hep.32269

Cited by 28 publications

(29 citation statements)

References 5 publications

(9 reference statements)

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“…Although all four were in clinical remission prior to vaccination, immune stimulatory events, including infections or vaccinations, may induce a relapse of previously stable AIH [ 12 ]. Indeed, another case that fits this description was recently published [ 13 ]. In these situations, management will mirror that of a typical AIH flare, with a brief corticosteroid re-induction and possible adjustment of maintenance immunosuppression.…”

Section: Introductionmentioning

confidence: 54%

Autoimmune Hepatitis-Like Syndrome Following COVID-19 Vaccination: Real or Imagined?

Shroff

Fix

2022

Dig Dis Sci

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Section: Introductionmentioning

confidence: 54%

Autoimmune Hepatitis-Like Syndrome Following COVID-19 Vaccination: Real or Imagined?

Shroff

Fix

2022

Dig Dis Sci

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“…Several cases developed acute liver injury following COVID-19 vaccination [ 22 ], including acute exacerbation of AIH [ 23 , 24 ]. Such acute insult of the liver could act as a trigger of ACLF in decompensated cirrhosis.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 vaccines in patients with decompensated cirrhosis: a retrospective cohort on safety data and risk factors associated with unvaccinated status

et al. 2022

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Background Safety data reported from the large-scale clinical trials of the coronavirus disease 2019 (COVID-19) vaccine are extremely limited in patients with decompensated cirrhosis. The vaccination campaign in this specific population could be difficult due to uncertainty about the adverse events following vaccination. We aimed to assessed the COVID-19 vaccination rate, factors associated with unvaccinated status, and the adverse events following vaccination in patients with decompensated cirrhosis. Methods This is a retrospective study from Ruijin Hospial (Shanghai, China) on an ongoing prospective cohort designed for long-term survival analysis of decompensated cirrhotic patients who recovered from decompensating events or acute-on-chronic liver failure (ACLF) between 2016 and 2018. We assessed the COVID-19 vaccination rate, the number of doses, type of vaccine, safety data, patient-reported reasons for remaining unvaccinated, factors associated with unvaccinated status, and the adverse events of COVID-19 vaccine. Binary logistic regression was used for identifying factors associated with unvaccinated status. Results A total of 229 patients with decompensated cirrhosis without previous SARS-CoV-2 infection participated (mean age, 56 ± 12.2 years, 75% male, 65% viral-related cirrhosis). Mode of decompensation were grade II‒III ascites (82.5%), gastroesophageal varices bleeding (7.9%), hepatic encephalopathy (7.9%). Eighty-five participants (37.1%) received at least one dose of vaccination (1 dose: n = 1, 2 doses: n = 65, 3 doses: n = 19) while 62.9% remained unvaccinated. Patient-reported reasons for remaining unvaccinated were mainly fear of adverse events (37.5%) and lack of positive advice from healthcare providers (52.1%). The experience of hepatic encephalopathy (OR = 5.61, 95% CI: 1.24–25.4) or ACLF (OR = 3.13, 95% CI: 1.12–8.69) and post-liver transplantation status (OR = 2.47, 95% CI: 1.06–5.76) were risk factors of remaining unvaccinated independent of residential areas. The safety analysis demonstrated that 75.3% had no adverse events, 23.6% had non-severe reactions (20% injection-site pain, 1.2% fatigue, 2.4% rash) and 1.2% had a severe event (development of acute decompensation requiring hospitalization). Conclusions Patients with decompensated cirrhosis in eastern China are largely remained at unvaccinated status, particularly those with previous episodes of ACLF or hepatic encephalopathy and liver transplantation recipients. Vaccination against COVID-19 in this population is safe. Graphical Abstract

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“…Several case reports have described development of liver injury following severe acute respiratory syndrome‐coronavirus 2 (SARS‐CoV‐2) vaccination in hepatology . [ 1 , 2 ] These cases showed autoimmune hepatitis (AIH) features, and all cases responded well to corticosteroid therapy. Herein, we present a patient who underwent liver transplantation due to fulminant liver failure following vaccination with the BioNTech vaccine.…”

Section: Figurementioning

confidence: 99%

“…Interestingly, MRB was found to be no better than porto-systemic shunts in a recent meta-analysis of 257 children (Yamoto et al 2021). [2] Nevertheless, this is where the clear role of MRB ceases. In our cohort, more than 70% exhibited splenic/superior mesenteric vein thrombosis, explicit contraindications to MRB by the authors' own references.…”

mentioning

confidence: 99%

Letter to the editor: Liver transplantation following severe acute respiratory syndrome‐coronavirus‐2 vaccination–induced liver failure

Efe¹,

Harputluoğlu²,

Soylu³

et al. 2022

Hepatology

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Letter to the editor: Exacerbation of autoimmune hepatitis after COVID‐19 vaccination

Cited by 28 publications

References 5 publications

Autoimmune Hepatitis-Like Syndrome Following COVID-19 Vaccination: Real or Imagined?

Autoimmune Hepatitis-Like Syndrome Following COVID-19 Vaccination: Real or Imagined?

COVID-19 vaccines in patients with decompensated cirrhosis: a retrospective cohort on safety data and risk factors associated with unvaccinated status

Letter to the editor: Liver transplantation following severe acute respiratory syndrome‐coronavirus‐2 vaccination–induced liver failure

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