An illness resembling serum sickness occurs in about 10% of patients with acute hepatitis B infection and 5-10% of patients with acute hepatitis C infection.Joint involvement tends to be symmetric in systemic diseases such as rheumatoid arthritis, systemic lupus erythematosus, polymyalgia rheumatica, viral arthritides, and serum sickness reactions.CMV infection, serum sickness, or another viral il