A Case-control study of the combined therapy with glucocorticoid and antiviral treatment at early-stage of severe chronic hepatitis B

Objective To assess the clinical effect of glucocorticoid in the treatment at the early-stage of severe chronic hepatitis B. Methods Fifty-six patients with early-stage HBV-related liver failure were divided randomly into glucocorticoid treatment group (experimental group) and routine integrated treatment group (control group). The total bilirubin (TBil), alanine transaminase (ALT), prothrombin time (PT) and the incidence of complications before and after the treatments in both groups were compared. Results (1) ALT decreased significantly after treatment in both groups(P 0.05). (2) In the experimental group, TBil and PT decreased significantly after treatment (P 0.05). White blood cells count was significantly higher in the experimental group than control group after treatment (P<0.05), but still in the normal range. Conclusions The short-term moderate-dose of glucocorticoid treatment can improve liver functions and coagulation function of patients with HBV-related early-stage liver failure. Gulcocorticoid treatment will not increase the incidences of common complications, including gastrointestinal bleeding, infection, hepatic encephalopathy (HE), etc. However, the exact clinical effect of glucocorticoid needs further research. Key words: Glucocorticoid; Antiviral treatment; Severe hepatitis; Hepatitis B