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Twenty-seven cases of AIH are summarized in this study, providing emerging evidence of autoimmune reactions in response to various COVID-19 vaccines, including in patients with special disease backgrounds such as primary sclerosing cholangitis (PSC), liver transplantation, and previous hepatitis C virus (HCV) treatment. Molecular mimicry, adjuvants, epitope spreading, bystander activation, X chromosome, and sceptical hepatotropism of SARS-CoV-2 may account for, to some extent, such autoimmune phenomena. Immunosuppressive corticosteroids perform well with or without azathioprine in such post-COVID-19-vaccination AIH. However, determination of the exact mechanism and establishment of causality require further confirmation.<\/jats:p>","DOI":"10.3389\/fimmu.2022.1035073","type":"journal-article","created":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T05:46:41Z","timestamp":1669355201000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":31,"title":["Autoimmune hepatitis after COVID-19 vaccination"],"prefix":"10.3389","volume":"13","author":[{"given":"Han","family":"Zheng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiyao","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinting","family":"Sang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,11,25]]},"reference":[{"key":"B1","unstructured":"COVID-19 map: Johns Hopkins coronavirus resource center2022"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2021.1945901","article-title":"Landscape and progress of global COVID-19 vaccine development","volume":"17","author":"Huang","year":"2021","journal-title":"Hum Vaccin Immunother"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1038\/s41563-020-0746-0","article-title":"Next-generation vaccine platforms for COVID-19","volume":"19","author":"van Riel","year":"2020","journal-title":"Nat Mater"},{"key":"B4","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1111\/imm.13443","article-title":"New-onset autoimmune phenomena post-COVID-19 vaccination","volume":"165","author":"Chen","year":"2022","journal-title":"Immunology"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2021.2833","article-title":"Myocarditis following immunization with mRNA COVID-19 vaccines in members of the US military","volume":"6","author":"Montgomery","year":"2021","journal-title":"JAMA Cardiol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2021012152","article-title":"Vaccine-induced immune thrombotic thrombocytopenia: what we know and do not know","volume":"138","author":"Arepally","year":"2021","journal-title":"Blood"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2021.102941","article-title":"Autoimmunity roots of the thrombotic events after COVID-19 vaccination","volume":"20","author":"Elrashdy","year":"2021","journal-title":"Autoimmun Rev"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2021.102951","article-title":"IgA vasculitis in adult patient following vaccination by ChadOx1 nCoV-19","volume":"20","author":"Badier","year":"2021","journal-title":"Autoimmun Rev"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2020.102534","article-title":"The role of complement activation in autoimmune liver disease","volume":"19","author":"Biewenga","year":"2020","journal-title":"Autoimmun Rev"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2020.102597","article-title":"Covid-19 and autoimmunity","volume":"19","author":"Ehrenfeld","year":"2020","journal-title":"Autoimmun Rev"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.04.003","article-title":"Autoimmune hepatitis developing after coronavirus disease 2019 (COVID-19) vaccine: Causality or casualty","volume":"75","author":"Bril","year":"2021","journal-title":"J Hepatol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.04.039","article-title":"Comment on \u201cAutoimmune hepatitis developing after coronavirus disease 2019 (COVID-19) vaccine: Causality or casualty","volume":"75","author":"Capecchi","year":"2021","journal-title":"J Hepatol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.05.038","article-title":"Autoimmune hepatitis following SARS-CoV-2 vaccine: May not be a casuality","volume":"75","author":"Rocco","year":"2021","journal-title":"J Hepatol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.06.004","article-title":"Another case of autoimmune hepatitis after SARS-CoV-2 vaccination - 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