Aflatoxin B₁ exposure and the risk of hepatocellular carcinoma in Iranian carriers of viral hepatitis B and C

Abstract

Hepatocellular carcinoma (HCC) is known as one of the common and fatal cancers in the Asian and African countries. Two significant factors could cause this type of cancer including having diets contaminated with aflatoxin and chronic viral hepatitis infections. This study aimed to compare the level of aflatoxin B₁ (AFB₁) in those who had viral hepatitis B- and C-related HCC as a case group and a group of patients with chronic hepatitis B or C infections as the control group. This case-control study was conducted on 82 patients including 41 patients with viral hepatitis-related HCC and 41 patients with chronic hepatitis B or C infections. Level of AFB₁ was measured using ELISA and compared between groups. Most of the patients in both groups were male and infected with HBV. The patients with HCC with mean age 57.5 years were significantly older than those in the control group with mean age 44.8 years (p < .05). Aflatoxin B₁ was detected in 32 (78%) samples in HCC group and 28 (68.3%) samples in non-HCC group (p > .05). The median (IQR) for AFB₁ levels in HCC group was 3.87 (3.46) pg/mL, while it was 2.63 (3.14) pg/mL in the control group (p = .018). Our results demonstrate for the first time the exposure to high levels of AFB₁ in Iranian patients with HCC which indicate the possible involvement of AFB₁ as a major risk factor in the etiology of HCC in patients with hepatitis B and C.

Keywords:

• Aflatoxin B₁
• hepatitis B
• hepatitis C
• hepatocellular carcinoma
• Iran

Acknowledgements

The authors especially thank The Baqiyatallah Research Center for Gastroenterology and Liver Diseases. In addition, the authors thank the Iran Hepatitis Network, transplantation ward of Imam Khomeini Hospital of Tehran, Namazi Hospital of Shiraz, Resalat Medical Laboratory, Narmak Medical Laboratory and Keyvan Virology Laboratory for their kind help in preparing patients samples.

Compliance with ethical standards: The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008.

Disclosure statement

The authors declare they have no conflict of interest.