Objective        To determine the effect of glucocorticoid on the serum level of IL-1α in patients with severe chronic hepatitis B (CHB) and its clinical significance.       Methods        A total of 92 patients with chronic HBV infection in- and out-patients (containing 72 cases with severe CHB and 20 cases of chronic asymptomatic HBV virus carriers) in our institute from May 2006 to June 2013 were subjected in this study. Another 2

0 healthy age- and sex-matched individuals for physical examination from June 2012 to June 2013 served as normal control. The asymptomatic carriers and healthy control groups were given no treatment

while those with severe CHB were divided into 2 subgroups

and given conventional medication in presence of glucocorticoid (n=34) or not (n=38). The serum level of IL-1α was tested by enzyme linked immunosorbent assay ( ELISA) in the 72 severe CHB patients at day 0 (onset of treatment)

days 5 and 14 during treatment

and in 20 asymptomatic carriers and 20 healthy controls. The effects of glucocorticoid on serum IL-1α level

liver function and prognosis among patients with severe CHB were analyzed and compared.       Results        The serum IL-1α level was higher in severe CHB patients than asymptomatic carriers and healthy individuals (

P

0.01). The level was lower in the patients with glucocorticoid treatment than those without at days 5 during treatment

P

0.01). The incidence of liver failure was lower in those with glucocorticoid treatment than those without (

P

=0.03). The serum T-Bil level was lower in these glucocorticoid treated patients at day 5 than those without at day 5 during treatment and those with glucocorticoid at day 0. (

P

0.01). In the patients with glucocorticoid treatment

the serum level of IL-1α was significantly positively correlated with the serum level of T-Bil (r

s

=0.308

P

0.05)

and negatively correlated with the prothrombin activity [PTA(%)

]

(r

s

=-0.409

P

0.05).       Conclusion        Glucocorticoid is effective in preventing progression of severe CHB

and it may be due to its significantly reducing the serum IL-1α level in severe CHB patients.