Arthritis and HB Ag-Positive Hepatitis

Recently we called attention to the previously well-described but little-known association of arthritis with viral hepatitis.¹ Although our cases were not observed at the time of appearance of jaundice, the patients reported that the joint symptoms resolved completely coincident with its appearance. This pattern of resolution fits the previous descriptions by others, except for the original report of Robert Graves,² who wrote that the arthritis and jaundice coincided.

We recently observed two instances of hepatitis B antigen (HB Ag)-positive hepatitis in surgical housestaff members heavily exposed to a patient who subsequently developed HB Ag hepatitis. Four of five of the team of surgeons who operated on this patient contracted the disease and three of the four had arthritis. The index patient also had arthritis. The housestaff epidemic itself has been described elsewhere.³ We recorded the rheumatologic findings in these patients and in a third member of the