The therapeutic efficacy of antiviral therapy against chronic viral infections and anticancer strategy against cancers is not satisfactory. Most of the antiviral drugs cause reduction of viral replication in chronic virus-infected subjects, however, recovery or cure from diseases does not occur in most cases. Various types of therapeutic approaches, such as ablation of cancer tissues, use of anticancer drugs and radiation therapy, are applied to treat patients with cancers. But, recurrence of cancer is a formidable problem in clinics. Taken together, sustained control of virus replication in chronic viral carriers and control of cancer recurrence in cancer patients are two major challenges. It is now evident that although different factors are responsible for pathogenesis of chronic viral infections and cancers, almost all patients exhibit distorted antiviral and anticancer immune responses. Thus, a new field of treatment of these diseases by immune intervention has been emerged. Immune therapy against chronic viral infections and cancers are in their infancy and facing several challenges. These challenges will be discussed to provide a road map for development of clinically-acceptable and potent immune therapeutic approaches against these diseases, especially in the context of liver diseases.

Background/Aim: The role of hepatitis C virus (HCV) has been demonstrated in many autoimmune diseases, including the autoimmune thyroid disease. However, there is paucity of information about the prevalence of extrahepatic autoimmune phenomenon in HCV-infected patients from Egypt and developing countries. This study checked the prevalence of antithyroid autoantibodies in patients with chronic HCV infection and their possible relation to the human leukocyte antigen (HLA) status. Patients and methods: Sera from 147 consecutive patients (75 males and 72 females) with chronic HCV infection at the Mansoura University Hospitals, Egypt during 2008 to 2009, were analyzed for antithyroid antibodies (group 1). A total of 126 anti-HCV positive patients without antithyroid antibodies were enrolled as controls (group 2). Thyroid microsomal and thyroglobulin autoantibodies were determined by the hemagglutination tests. IgG type anti-GOR were measured using an ELISA assay. HLA-A,-B, -C and -DR were determined using the standard complement-dependent microdroplet lymphocyte cytotoxicity test. Results: Antithyroid antibodies were detected in 21 HCV RNA positive patients (group 1; 18 females, 3 males) and remaining 126 patients (group 2; 72 males and 54 females). The prevalence of anti-GOR antibodies was significantly higher in patients of group 1 compared to that of group 2. A statistically significant difference was observed regarding anti-GOR antibodies in group 1 (p < 0.001), antithyroid autoantibodies among the females (p < 0.001). HLA-A2 antigen was prevalent in group 1 (p < 0.05). Conclusion: Our data revealed that HLA-A2 may be regarded as an immunologic risk factor for the development of antithyroid autoantibodies in patients with chronic HCV infection and these autoantibodies should be evaluated prior to initiating IFN-α therapy.

Background/Objective: Hepatitis B virus (HBV) infection has remained a global public health challenge. Nigeria is in the high endemicity group with a prevalence of 8% or higher. The authors seized the opportunity of the 2010. World Hepatitis Day to mount a public enlightenment campaign and also screen civil servant in Enugu State of Nigeria for the infection. Materials and methods: In this cross-sectional study, civil servants attached to Government House, Enugu, Nigeria, were administered a structured questionnaire containing the putative risk factors for HBV transmission. They also underwent screening for hepatitis B surface antigen (HBsAg) in blood. Results: Out of 395 civil servants (206 males and 189 females) who participated in the screening, 36 were position for HBsAg giving a seroprevalence of 7.6%. Majority of the seropostive subjects (86.7%) were females (p < 0. 001). Among the risk factors examined, past history of native uvulectomy, sharing of toothbrush, sharing of razor blades and hair clippers were significantly more prevalent in the HBsAg positive group compared to the HBsAg negative subjects. In the females who had circumcision, the HBsAg seroprevalence was significantly higher than in the uncircumcized group (p = 0.014, odds ratio = 3.13). Conclusion: The seroprevalence of HBsAg in civil servants of Enugu State of Nigeria was 7.6%. More females than males were HBsAg seropositive and this may be related to previous circumcision in the females.

Background and aim: To find the degree of knowledge and awareness about hepatitis A virus (HAV) and hepatitis B virus (HBV). We also evaluated practices of vaccination among the medical students of Chittagong Medical College, Chittagong, Bangladesh. Materials and methods: A total of 125 students of Chittagong Medical College, 25 each from first year to 5th year were selected by stratified and simple random sampling. Information about knowledge, awareness and practices of hepatitis A and B vaccination was collected by selfadministered questionnaire along with direct observation of the respondents. Results: About 6.4% and 87% of the students were aware for vaccination against hepatitis A and hepatitis B respectively. None of the students had taken vaccine against hepatitis A whereas two-thirds of the students had been vaccinated for hepatitis B. Discussion and conclusion: Almost all students were unaware of vaccine against hepatitis A. In contrast, most of the students were aware about vaccine against hepatitis B. Despite the fact that vaccination program being priority National Public Health Program, vaccination procedures had not been implemented well in reality. Awareness of hepatitis A on preventive activities, such as increased utilization of safe water and handwashing practices should be strengthened.

Chronic consumption of pan masala plain (PMP) or with tobacco (PMT) cause liver injury. Three groups of mice of both sexes consuming PMP, PMT and control diet for prolonged period were enrolled in this study. Blood samples were collected 16, 56 and 70 weeks after study commencement and checked for serum alkaline phosphotase, glutamic oxaloacetic transaminase and glutamic pyruvic transaminase. Significant increased levels of all these enzymes were found in mice provided with PMP and PMT compared to control mice, however, elevation in the intermittent samples varied between PMP and PMT groups. This study has indicated the liver injury potential of pan masala and their effects should be assessed in human.

Arteriobiliary fistula during transarterial chemoembolization (TACE) is very rare. However, it is vital to manage the arteriobiliary fistula to prevent the life-threatening complications of hemobilia. This study deals with an arteriobiliary fistula identified during the procedure of TACE undertaken for the treatment of hepatocellular carcinoma (HCC) and managed successfully by embolizing the proximal segmental hepatic artery using microcoil.

Background: Pulmonary tuberculosis (TB) is one of the common infections in developing countries of Asia and Africa, however, little is known about hepatic tuberculosis from these countries. Case report: We report a case of hepatic tuberculosis in a 24-year-old Bangladeshi man. He attended the physician for evaluation of hepatitis B surface antigen. He was asymptomatic with no notable hepatic and pulmonary complains. A diagnosis of hepatic TB was made after evaluation of liver histology that exhibited epitheloid granuloma with central caseating necrosis in the liver. The patient was successfully treated by antitubercular drugs. Discussion: Involvement of liver in TB may occur in a variety of forms. The commonest form is disseminated tuberculosis. A second variety represents diffuse involvement of liver with granuloma formation (granulomatous hepatitis). This is the first reporting of hepatic TB from Bangladesh, a country that harbors millions of people infected with TB and hepatitis viruses.