Hb-drug conjugates (HDCs) may improve the safety and efficacy of the attached drugs for treatment of liver viral infection and cancer.HDCs target drugs to liver cells through the endogenous pathway for Hb catabolism through the liver.Several nucleoside drugs including ribavirin (an essential co-therapy for hepatitis C virus infection with significant dose-limiting toxicity) were conjugated to Hb as 5′-monophosphoramidates, allowing for intracellular drug release.HDCs with molar drug ratios up to 15 retained the ability to bind haptoglobin (the natural ligand for acellular Hb) and to be taken up by cells expressing the Hb-haptoglobin receptor, CD163.In a viral hepatitis mouse model, ribavirin-HDC prolonged survival, improved behavior, and reduced histol. signs of disease.Viral replication and inflammatory cytokine production were inhibited in vitro.HDCs of the anti-cancer nucleoside floxuridine showed increased cytotoxicity against lymphoma cells expressing CD163.Further investigation of HDCs for targeted therapy of hepatic diseases is warranted.