AbstractIn 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 s