[Glycocorticosteroid administration prevents fulminant hepatic failure occurrence in patients with chronic hepatitis B of severe degree].
OBJECTIVE
To prevent chronic severe hepatitis, even more fulminant hepatic failure (FHF) occurrence in patients with chronic hepatitis B of severe degree using steroid.


METHODS
120 patients were randomized into conventional supporting treatment and steroid treatment groups. The latter, 62 patients were given intravenously hydrocortisone sodium succinate at the dose of 150 mg to approximately 200 mg everyday plus support care.


RESULTS
The rate of deteriorating to chronic severe hepatitis in steroid treatment group was significantly lower than that of conventional group (22% vs 48%, x(2) =7.60, P<0.01). 53.6% (15/28) patients with chronic severe hepatitis in conventional group died, while only 28.6% (4/14) in steroid treatment group succumbed to terminal liver disease (x(2)=0.02, P>0.05). There was no difference between the two groups regarding to complications incidence: gastrointestinal bleeding and infections except for some controllable serious reverse events, such as candidiasis, diabetes, herpes zoster and pulmonary tuberculosis found in some patients in steroid-treated group.


CONCLUSIONS
These results suggest that steroid administration with improved support care not only is likely to prevent chronic severe hepatitis occurrence in patients with chronic viral hepatitis of severe degree, but also shows some efficacy for FHF, which warrant further investigation.
Chen
Cong-xin
CX
Department of Infectious Diseases, 105th Hospital of People's Liberation Army, Hefei 230031, China.
Guo
Shun-ming
SM
Liu
Bo
B
Yang
Jia-hong
JH
Xu
Ning
N
Liu
Ke-wan
KW
D000328:Adult; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D019694:Hepatitis B, Chronic / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D017093:Liver Failure / Q000517:prevention & control*; D008297:Male
D005938:Glucocorticoids