RESUMEN
AIM: we have analyzed the peculiarities of NS3Ag expression in hepatocytes and dependence of necroinflam mation on the NS3Ag level and on its localization in hepatocytes in patients with different genotypes of HCV MATERIALS AND METHODS: 31 patients with chronic hepatitis C were examined, 14 (45%) of them with HCV geno type 1b and 17 (55%) with genotype 3a. NS3Ag was detected in the liver tissue by immunohistochemistry ("Novocastra" kit, UK). Routine laboratory analyses were performed. Staging and grading were assessed according to the Knodell score and a modified method, and sclerosis index was determined according to the Metavir scale. RESULTS: the level of NS3Ag in the cytoplasm of hepatocytes was 140 fold higher than in the nucleus. Different patterns of NS3Ag localization in the cytoplasm were observed: in 19 (61%) patients it was detected peripherally near the plasma membrane, whereas in 12 (39%) patients it was diffusely distributed in the cytoplasm. Necroinflammation was more pronounced in the case of peripheral near-membrane NS3Ag localization. The fatty an hydropic degeneration and small cell dysplasia of hepatocytes were more significant in high NS3Ag concentration. No correlation was revealed between the intracytoplasmic NS3Ag localization and the genotype of HCV. However, biochemical activity and the severity of inflammation and fibrosis in all zones of the acinus were highe in patients with HCV genotype 1b, in spite of the lower viral load compared with the patients with genotype 3a CONCLUSIONS: in chronic hepatitis C, cytoplasmatic expression of NS3Ag prevailed over nuclear expression. Sever ity of necroinflammation was higher in patients with peripheral near-membrane NS3Ag localization than in those with uniform diffuse localization. The degree of parenchymatous damage and small cells dysplasia of he patocytes depended on the level of NS3Ag in hepatocytes. In patients with HCV genotype 1b, biochemical an histologic indicators of activity were higher, while NS3Ag concentration was lower compared to genotype 3a.