Peculiarities of the Expression of Immunohistochemical Marker HCV nS3 in the Autopsy Brain of the Patients Died in the Outcome of Chronic Infection, Caused by Hepatitis C Virus

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Background . Brain lesion is one of the most common extrahepatic manifestations of chronic HCV infection. To date, its main clinical and neurometabolic features have been established. However, the morphological picture of HCV-associated cerebral changes and peculiarities of viral molecular markers expression in brain matter remain poorly understood. This significantly limits the possibilities of pathological diagnosis of this disease. Aims . To study the morphological picture of brain lesion during chronic HCV infection and to determine the peculiarities of immunohistochemical (IHC) expression of the HCV NS3 antigen in brain matter. Materials and methods . The study was performed on autopsy brain of 40 patients who died in the outcome of HCV infection and 15 patients died without signs of mental pathology. Complex of pathomorphological and ICH methods was used. Results . It was demonstrated that morphological picture of brain lesion in chronic HCV infection is represented by nonspecific dystrophic, inflammatory and proliferative changes, the severity of which varies significantly depending on the brain departments (p < 0.001). Expression of the NS3 marker is found in all studied brain regions and shows the highest intensity in white matter of cerebral hemispheres and in brain stem (p < 0.05). The ICH reaction of NS3 is manifested in microglia cells, vascular endothelium, inflammatory infiltrate cells and in periventricular ependyma cells. Using correlation analysis method it was found that NS3 expression formed the strongest correlations with such categories as CD68 expression, microgliosis, and axonal degeneration. This allows considering they are the main factors by which HCV realizes its deleterious effect on the brain. Conclusion . Characteristic morphological changes of the brain in chronic HCV infection were studied. The features of ICH expression of the NS3 in various parts of the brain are established. The results can be used to improve pathological diagnosis of brain lesion in chronic HCV infection.