Jorge Rakela

Acute type a hepatitis in three patients with chronic HBV infection

We have studied three patients with chronic HBV infection who had a superimposed bout of type A hepatitis. The patients recovered uneventfully without observing a change in their clinical course afterwards. In one patient we observed transient disappearance of DNA polymerase during type A hepatitis; we have postulated that this is probably related to hepatic necrosis.

Immunologic studies and clinical follow-up HBsAg-positive polyarteritis nodosa

Three patients with hepatitis B surface antigen (HBsAg)-positive polyarteritis nodosa (PAN) who are clinically well 41/2–51/2 years after their initial illnesses are described. In each case electron microscopic studies demonstrated the presence of aggregates of HBsAg in both acute and quiescent phase sera. One patient had a lower circulating HBsAg titer during the acute illness, while no change in serial HBsAg titers was observed in the other two patients. Two of the three patients showed lymphocyte transformation to purified HBsAg during the quiescent phase of the PAN. The role of immune complexes in the pathogenesis of HBsAg-positive PAN is discussed.