Outcomes and factors associated with relapse of vaccine-induced liver injury after SARS CoV-2 immunization: A nationwide study.

Autor:	Barreira-Díaz A; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Liver Unit, Hospital Universitario Vall de Hebrón, Barcelona, Spain., Riveiro-Barciela M; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Liver Unit, Hospital Universitario Vall de Hebrón, Barcelona, Spain. Electronic address: mar.riveiro@gmail.com., Fernández-Bonilla EM; Gastroenterology and Hepatology Department, Miguel Servet University Hospital, Zaragoza, Spain., Bernal V; Gastroenterology and Hepatology Department, Miguel Servet University Hospital, Zaragoza, Spain., Castiella A; Liver Unit, Donostia University Hospital, Donostia, Spain., Casado-Martín M; Digestive Department, Complejo Hospitalario Torrecárdenas, Almeria, Spain., Delgado C; Digestive Department, Hospital Universitario de Toledo, Spain., Londoño MC; Institut D'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Health Care Provider of the European Reference Network on Rare Liver Disorders (ERN-Liver), Liver Unit, Hospital Clínic Barcelona, University of Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain., Díaz-González Á; Department of Gastroenterology and Hepatology, Marqués de Valdecilla University Hospital, Valdecilla Biomedical Research Institute (IDIVAL), Santander, Spain., Pérez-Medrano I; Gastroenterology and Hepatology Department, Complejo Hospitalario Universitario de Pontevedra, Spain., Conthe A; Hepatology and Liver Transplantation Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain., Sala M; Gastroenterology Department, Hospital Universitari Josep Trueta, Girona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain., Mateos B; Digestive Department, Hospital Ramón y Cajal, Madrid, Spain., Gómez-Camarero J; Digestive Department, Hospital Universitario de Burgos, Spain., Antón-Conejero D; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Digestive Department, Hospital Universitario Dr. Peset, Valencia, Spain., Pozo-Calzada CD; Digestive Department, Hospital Clínico Universitario de Valladolid, Spain., Cuenca F; Gastroenterology Department, Hospital Clínico San Carlos, Madrid, Spain., Villagrasa-Vilella A; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Liver Unit, Hospital Universitario Vall de Hebrón, Barcelona, Spain., Salcedo M; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Hepatology and Liver Transplantation Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Jazyk:	angličtina
Zdroj:	Annals of hepatology [Ann Hepatol] 2024 May-Jun; Vol. 29 (3), pp. 101489. Date of Electronic Publication: 2024 Feb 23.
DOI:	10.1016/j.aohep.2024.101489
Abstrakt:	Introduction and Objectives: Different patterns of liver injury have been reported in association with the SARS-CoV-2 vaccines. The aim of this study was to describe a nationwide cohort of patients with SARS CoV-2 vaccine-induced liver injury, focusing on treatment and the evolution after further booster administration. Patients and Methods: multicentre, retrospective-prospective study, including subjects who developed abnormal liver tests within 90 days after administration of SARS-CoV-2 vaccination. Results: 47 cases were collected: 17 after prime dose and 30 after booster. Age was 57 years, 30 (63.8 %) were female, and 7 (14.9 %) had a history of prior autoimmune hepatitis (AIH). Most cases were non-severe, though 9 (19.1 %) developed acute liver injury or failure (ALF). Liver injury tended to be more severe in those presenting after a booster (p=0.084). Pattern of liver injury was hepatocellular (80.9 %), mixed (12.8 %) and 3 (6.4 %) cholestatic. Liver biopsy was performed on 33 patients; 29 showed findings of AIH. Forty-one (87.2 %) patients received immunosuppressants, mostly corticosteroids (35/41). One required liver transplantation and another died due to ALF. Immunosuppression was discontinued in 6/41 patients without later rebound. Twenty-five subjects received at least one booster and 7 (28.0 %) relapsed from the liver injury, but all were non-severe. Recurrence was less frequent among patients on immunosuppressants at booster administration (28.6 % vs. 88.9 %, p=0.007). Conclusions: SARS CoV-2 vaccine-induced liver injury is heterogeneous but mostly immune-mediated. Relapse of liver injury after re-exposure to vaccine is frequent (28.0 %) but mild. Immunosuppression at booster administration is associated with a lower risk of liver injury. Competing Interests: Conflicts of interest None. (Copyright © 2024 Fundación Clínica Médica Sur, A.C. Published by Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu