In chronic virus hepatitis C, two types of structural changes dominate in hepatocytes: multivesicular lipid infiltration and cell involution degeneration characterized by reduction of all cytoplasmic organelles and light-optic phenomenon of cytoplasma depletion with preserved structure of the nuclear compartment. These changes can be considered as adaptive cell response to cytopathic influence of hepatitis C virus. Key Words: hepatitis C virus; hepatocytes; degeneration; regeneration; pathomorphologyHepatitis C virus (HCV) genome contains single-strand RNA encoding structural and nonstructural viral proteins. HCV infection, one of the most common cause of morbidity and mortality in the world [8], induces a wide spectrum of liver disorders from silent carrier state to fatal hepatic insufficiency. HCV infection is characterized by a higher rate of transformation to chronic disease in comparison with other hepatotropic viruses. HCV infection is also associated with the development of hepatocellular carcinoma [ 13].The role of viral cytopathic effects remains poorly understood, since experimental models, in particular transgene expression of HCV structural proteins, revealed no histological changes related to the expression of these proteins in animals [12].The aim of the present study was to analyze cell and intracellular reactions of the liver in chronic hepatitis C verified by clinical, biochemical, and immunoserological tests. MATERIALS AND METHODSAutopsy materials (46 samples) from 37 patients with chronic hepatitis C obtained through transcutaneous Laboratory of Ultrastructure Basis of Pathology, Institute of Regional Patholo~jy and Pathomorpholo9y, Siberian Division of the Russian Academy of Medical Sciences, Novosibirsk biopsy were analyzed. Each specimen was divided into 2 parts: the larger part was used for preparing paraffin sections, while the lesser samples were used for preparing semithin and ultrathin sections.For light microscopy, the specimens were fixed in 10% neutral formalin. Paratfin sections were stained with hematoxylin and eosin followed by Perls' reaction, according to van Gieson method combined with visualization of elastic fibers with Weigert resorcin-fuchsin, and PAS reaction was carried out.Electron microscopy specimens were fixed in 4% paraformaldehyde and processed routinely [2]. Semithin sections were stained with azur II and Schift reagent. Ultrathin sections were contrasted with uranyl acetate and lead citrate and examined under a JEM-1010 electron microscope.Stereological analysis of liver specimens was based on counting the test system points within the test structure [7,11]. Tissue structure was assessed on semithin sections. Structural density of different parenchymal and stromal components (hepatocytes, endotheliocytes, sinusoids, stroma, and cell infiltrates) was measured using an ocular test system consisting of short lines (n=36, P=72, L=650 la) and derivative stereological parameters (stroma to parenchyma and vessels to parenchyma ratios) were calculated. The differences wer...

Here we review modern notions about biological properties of hepatitis C virus, geographic distribution of its genotypes, peculiarities of immune reactions during chronic HCV infection, and role of viral replication in the infectious process. The concept of antiviral protection in liver parenchymal cells suggests suppression of biosynthetic reactions in hepatocytes resulting in inhibition of viral replication and focal degradation of the cytoplasm in infected cells followed by exocytosis and elimination of viral particles (cytosanation without cytodestruction). The recovery of structural characteristics in hepatocytes is associated with intracellular regeneration. Special accent is placed on reversibility of liver fibrosis in chronic HCV infection due to resorption of collagen fibers by hepatocytes. These data indicate that the therapy of liver fibrosis holds much promise.

Liver autopsy material from opioid addicts with viral hepatitis C and C+B showed hepatocyte dystrophy associated with lipid infiltration, hyperplasia of lymphoid tissue, and perivascular fibrosis. Alteration of hepatocytes were most pronounced in patients with hepatitis C+B. Ultrastructure of hepatocytes is characterized by a reduction of protein synthesizing compartment, an increase in volume density of smooth cytoplasmic reticulum, appearance of megamitochondria, and pronounced collagenization of the Disse space. Key Words: viral hepatitis; opium addiction; liver autopsy; hepatocytes; light and electron microscopyInfection with hepatitis C and B can now be transferred via medical instruments, thus adding to natural ways of infection. Spreading of the infections in intravenous drug addicts plays a special role, since it significantly promotes virus passage and aggravates infectious process by inducing structural rearrangements in the liver. Numerous experimental and clinical studies analyze the effects of narcotics alone [1,9,11,12] or in combination with hepatitis [13-15] on animal and human liver. However, there are only few reports on combined action of opium and hepatitis viruses [10].Previously, we reported structural reactions of the liver induced by chronic hepatitis C and C+B [4,5]. Here we present the results of examination of liver autopsy material from intravenous opium addicts suffering from chronic hepatitis C and C+B. MATERIALS AND METHODSThe diagnosis was based on clinical, biochemical, and immunoserologic data. The following antigens and antibodies were revealed: HBsAg, HBeAg, anti-HBcIgM, anti-HBs, anti-HBe, total anti-HCV, antibodies to core-and NS-antigens of hepatitis C virus. All serum samples were analyzed by polymerase chain reaction for the presence of HVC RNA. Hepatitis C and C+B were verified in 16 and 13 patients, respectively.Liver samples (n=36) were obtained from 29 patients by transcutaneous puncture biopsy. Paraffin, semithin, and ultrathin sections were examined. For light microscopy the samples were fixed in 10% neutral formaldehyde and stained routinely [7].For electron microscopy the samples were fixed in 4% paraformaldehyde and treated as described previously [3]. Semithin sections were stained with azure II and Schiff reagent. Ultrathin sections were con-0007 -4888/99/0009-0963522.00 9Kluwer Academic/Plenum Publishers