Periarteritis nodosa induced by the hepatitis B virus.

Polyarteritis nodosa (PAN) induced by the hepatitis B virus (HBV) is a rare condition whose incidence has decreased markedly over the last decade. HBV-related PAN is an acute condition that occurs within six months of HVB infection and shares many features with classic PAN. Some manifestations, however, are more common in HBV-related PAN, such as abdominal signs, renal failure, malignant arterial hypertension, and orchitis. Tests for antineutrophil cytoplasmic antibody are usually negative. Management combines a short course of steroid therapy, plasma exchanges, and antiviral drugs. The ten-year disease-free survival rate is 80%. Over half the patients develop antibody to Hbe and 24.4% to HBs.