Immunological treatment of liver tumors

Table 1 Child-Pugh classification

	A	B	C
Ascites	None	Controlled	Uncontrolled
Bilirubin (mmol/L)	<2.0	2.0-2.5	>3.0
Encephalopathy	None	Minimal	Advanced
PT (s prolonged)	<4.0	4.0-6.0	>6.0
INR	<2.0	2.0-3.0	>3
Albumin (g/L)	>3.5	3.0-3.5	<3.0

Table 2 Commonest viruses used as gene therapy vectors

Retroviruses	Adenoviruses	Adeno-associated virus (AAV)	Herpes virus
8kb, RNA enveloped	35 kb, DNA, non-enveloped	5 kb, single stranded DNA, non-enveloped	61 kb, double-stranded DNA
Activate proto-oncogene by insertional mutagenesis	Episomal, transient	Stable integration, high infectivity	Infect mainly neurons
Cause lymphoma	Highly immunogenic, causing inflammation and anaphylactic shock	Non-pathogenic; requires helper viruses such as Adenoviruses for replication and packaging in mammalian cells.	Cause cold sores or blisters in the genital areas
Inactivation of transgene in vivo	One case of death	Long-term expression in vivo	Cutaneous skin lesions