Hepatitis B and Immune-Complex Disease

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Abstract
Beginning in the early 1970s, several investigators observed an association of persistent infection with hepatitis B virus with extrahepatic vascular diseases of unknown cause, particularly polyarteritis nodosa1 , 2 (necrotizing vasculitis) and glomerulonephritis.3 In 1977 Levo et al.4 reported such an association with essential mixed cryoglobulinemia, a disease characterized clinically by purpura, arthralgia, and weakness, and pathologically by vasculitis. Among 30 patients, 20 had either hepatitis B surface antigen (HBsAg) or antibody to HBsAg (anti-HBs) or both in their serum, and 14 of 19 patients had either or both in cryoprecipitates of their plasma. Particles resembling hepatitis B virus were seen in . . .