biostudies-literatureFontana RJNIDDK NIH HHSNational Institute of Diabetes and Digestive and Kidney DiseasesNCRR NIH HHSNational Cancer InstituteNCI NIH HHS1496-1505https://www.ebi.ac.uk/biostudies/studies/S-EPMC11296936biostudies-literatureUnknown119(8)<h4>Introduction</h4>The aim of this study is to describe the presenting features, genetic factors, and outcomes of 23 adults who developed liver injury after coronavirus disease 2019 (COVID-19) mRNA vaccination.<h4>Methods</h4>Patients with suspected COVID-19 vaccine hepatitis were enrolled into the Drug-Induced Liver Injury Network. Causality was assessed using the Drug-Induced Liver Injury Network expert opinion score. High-resolution HLA sequencing was undertaken using Illumina platform.<h4>Results</h4>Amongst the 16 high causality cases, median time to onset was 16 days, median age was 63 years, and 75% were female. The injury was hepatocellular in 75% with a median alanine aminotransferase of 497 U/L, and 37% had jaundice. An antinuclear antibody and smooth muscle antibody were detecThe American journal of gastroenterologyERAP-1 and ERAP-2 Variants in Liver Injury After COVID-19 mRNA Vaccination: A US Multicenter Study.PMC11296936U01DK083027U01DK100928U01 DK065201U01 DK065211U01DK083020U01 DK083020U01 DK083027U01 DK100928U01DK065201U01DK065211U24 DK065176U01DK065184U24DK065176U01 DK065184Intramural ProgramM01 RR000042Watkins PBShroff HFontana RJVuppalanchi RGu JLi YJKleiner DEVan Wagner LBUS DILIN study groupfalseERAP-1 and ERAP-2 Variants in Liver Injury After COVID-19 mRNA Vaccination: A US Multicenter Study.<h4>Introduction</h4>The aim of this study is to describe the presenting features, genetic factors, and outcomes of 23 adults who developed liver injury after coronavirus disease 2019 (COVID-19) mRNA vaccination.<h4>Methods</h4>Patients with suspected COVID-19 vaccine hepatitis were enrolled into the Drug-Induced Liver Injury Network. Causality was assessed using the Drug-Induced Liver Injury Network expert opinion score. High-resolution HLA sequencing was undertaken using Illumina platform.<h4>Results</h4>Amongst the 16 high causality cases, median time to onset was 16 days, median age was 63 years, and 75% were female. The injury was hepatocellular in 75% with a median alanine aminotransferase of 497 U/L, and 37% had jaundice. An antinuclear antibody and smooth muscle antibody were detec2024-01-01T00:00:00Z2024 Aug2026-03-18T13:25:34.331Z2025-08-18T09:53:47.505ZS-EPMC112969363831474810.14309/ajg.0000000000002702