Hepatitis B viral markers in severe viral hepatitis: influence of steroid therapy.
In our double-blind randomized trial of methylprednisolone vs. placebo in severe viral hepatitis, 16 patients with hepatitis B (8 on steroid, 8 on placebo) were followed for at least 4 weeks. Four of the eight patients receiving methylprednisolone eventually died and all patients on placebo survived. Despite marked reduction in serum IgG in steroid-treated patients, the decline in HBsAg titer and disappearance of Dane particle markers was the same in both treatment groups. A nonspecific depression of anti-HBc was noted in patients given steroid. There is no evidence that corticosteroid therapy accelerates viral replication when the acute hepatitis is severe.
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