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Outcomes and factors associated with relapse of vaccine-induced liver injury after SARS CoV-2 immunization: A
Ana Barreira-Díaz1, Mar Riveiro-Barciela2, Eva María Fernández-Bonilla3
1Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Liver Unit, Hospital Universitario Vall de Hebrón, Barcelona, Spain.
Annals of Hepatology
|February 25, 2024
Summary
SARS-CoV-2 vaccine-induced liver injury is typically immune-mediated and heterogeneous. While re-exposure via boosters can cause frequent relapses, these are usually mild, and immunosuppression may reduce risk.
Area of Science:
- Hepatology
- Immunology
- Vaccinology
Background:
- SARS-CoV-2 vaccines have been associated with various liver injury patterns.
- Understanding vaccine-induced liver injury (VILI) is crucial for public health.
- Immune-mediated liver injury post-vaccination requires characterization.
Purpose of the Study:
- To describe a nationwide cohort of SARS-CoV-2 vaccine-induced liver injury.
- To analyze treatment strategies for VILI.
- To evaluate liver injury evolution after booster doses.
Main Methods:
- Multicenter, retrospective-prospective study design.
- Inclusion of patients with abnormal liver tests within 90 days post-SARS-CoV-2 vaccination.
- Analysis of clinical presentation, treatment, and outcomes.
Main Results:
- 47 cases of VILI identified; 30 occurred after booster doses.
- Hepatocellular injury was predominant (80.9%); 19.1% developed acute liver failure.
- 28.0% of patients relapsed after a booster, but relapses were non-severe; immunosuppression at booster reduced recurrence.
Conclusions:
- SARS-CoV-2 VILI is heterogeneous and predominantly immune-mediated, often resembling autoimmune hepatitis.
- Liver injury relapse post-booster is common (28.0%) but generally mild.
- Prophylactic immunosuppression during booster administration is associated with a significantly lower risk of VILI recurrence.
Keywords:
Autoimmune hepatitisDrug-induced liver injuryHepatotoxicityLiver transplantationSARS CoV-2VaccineMore Related Videos
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