Autoimmune Hepatitis after AstraZeneca Coronavirus Disease 2019 (COVID-19) vaccine: need for epidemiological study

Abstract

This case-report and brief review of literature were written concerning autoimmune hepatitis potentially triggered by virus vaccines. Soon after the Astrazeneca COVID-19 vaccine, a 70-year-old women presented with jaundice and nausea, with significant hepatic injury (aspartate aminotransferase (AST) 746 U/L; hyperbilirubinemia 9,30 mg/dL (conjugated bilirubin 7,14 mg/dL), elevated immunoglobulin (Ig) G and antinuclear, anti-smooth muscle and anti-actin F antibodies were detected. Considering autoimmune hepatitis (AIH) as a possible cause, a liver biopsy was performed and compatible with AIH. Prednisolone therapy was initiated, with optimal response. This report suggests that immunization against COVID-19 might precipitate or induce AIH. Further data regarding confirmed cases of AIH are mandatory in order to establish a causal link. Therefore, long-term pharmacovigilance surveillance of large cohorts of patients is needed.