Zhou Hao, Ye Qing
Department of Laboratory Medicine, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou 310000, China.
Diseases. 2023 May 30;11(2):80. doi: 10.3390/diseases11020080.
Autoimmune hepatitis (AIH) is an inflammatory liver disease wherein the body's immune system instigates an attack on the liver, causing inflammation and hepatic impairment. This disease usually manifests in genetically predisposed individuals and is triggered by stimuli or environments such as viral infections, environmental toxins, and drugs. The causal role of COVID-19 vaccination in AIH remains uncertain. This review of 39 cases of vaccine-related AIH indicates that female patients above the age of 50 years or those with potential AIH risk factors may be susceptible to vaccine-related AIH, and the clinical features of vaccine-associated AIH are similar to those of idiopathic AIH. These features commonly manifest in patients after the first dose of vaccination, with symptom onset typically delayed by 10-14 days. The incidence of underlying liver disease in patients with potential health conditions associated to liver disease is similar to that of patients without preexisting illnesses. Steroid administration is effective in treating vaccine-related AIH-susceptible patients, with most patients experiencing improvement in their clinical symptoms. However, care should be taken to prevent bacterial infections during drug administration. Furthermore, the possible pathogenic mechanisms of vaccine-associated AIH are discussed to offer potential ideas for vaccine development and enhancement. Although the incidence of vaccine-related AIH is rare, individuals should not be deterred from receiving the COVID-19 vaccine, as the benefits of vaccination significantly outweigh the risks.
自身免疫性肝炎(AIH)是一种炎症性肝病,其中人体免疫系统会对肝脏发起攻击,导致炎症和肝功能损害。这种疾病通常在具有遗传易感性的个体中表现出来,并由病毒感染、环境毒素和药物等刺激因素或环境引发。COVID-19疫苗接种在AIH中的因果作用仍不确定。这篇对39例疫苗相关AIH病例的综述表明,50岁以上的女性患者或具有潜在AIH危险因素的患者可能易患疫苗相关AIH,且疫苗相关AIH的临床特征与特发性AIH相似。这些特征通常在患者接种第一剂疫苗后出现,症状发作通常延迟10 - 14天。有潜在肝脏相关健康状况的患者中潜在肝病的发生率与无既往疾病的患者相似。使用类固醇治疗对疫苗相关AIH易感患者有效,大多数患者的临床症状有所改善。然而,在给药期间应注意预防细菌感染。此外,还讨论了疫苗相关AIH可能的致病机制,为疫苗开发和改进提供潜在思路。尽管疫苗相关AIH的发生率很低,但个人不应因此而不敢接种COVID-19疫苗,因为接种疫苗的益处远大于风险。
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