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Acute viral B-hepatitis is the consequence of an effective specific immune response against the hepatitis B-virus with elimination of the virus. Corticosteroids decrease this immune reaction and thereby inhibit virus elimination. In principle, therefore, corticosteroid therapy promotes a transition to chronicity. This theoretical concept is documented practically by 8 patients treated with steroids in the early phase of acute viral hepatitis. Transition to some form of chronic liver disease is documented by serial liver biopsies in all 8 patients. The immunohistological findings showed the presence of HBsAg and HBcAg, as theoretically expected. These 8 selected cases, although uncontrolled, together with the theoretical concept of B-virus elimination, provide evidence against the use of corticosteroids in acute B-hepatitis.
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