Association of high viral load and abnormal liver function with high aflatoxin B₁–albumin adduct levels in HIV-positive Ghanaians: preliminary observations

Abstract

We examined the association between certain clinical factors and aflatoxin B₁–albumin adduct (AF-ALB) levels in HIV-positive people. Plasma samples collected from 314 (155 HIV-positive and 159 HIV-negative) people were tested for AF-ALB levels, viral load, CD4+ T-cell count, liver function profile, malaria parasitaemia, and hepatitis B and C virus infections. HIV-positive participants were divided into high and low groups based on their median AF-ALB of 0.93 pmol mg⁻¹ albumin and multivariable logistic and linear regression methods used to assess relationships between clinical conditions and AF-ALB levels. Multivariable logistic regression showed statistically significant increased odds of having higher HIV viral loads (OR = 2.84; 95% CI = 1.17–7.78) and higher direct bilirubin levels (OR = 5.47; 95% CI = 1.03–22.85) among HIV-positive participants in the high AF-ALB group. There were also higher levels of total bilirubin and lower levels of albumin in association with high AF-ALB. Thus, aflatoxin exposure may contribute to high viral loads and abnormal liver function in HIV-positive people and so promote disease progression.

Keywords:

• aflatoxins
• HIV
• liver function
• Ghana

Acknowledgements

The authors thank the study participants for making this study possible. They also thank Professor Ohene Adjei and Dr Thomas Kruppa, and other laboratory personnel at the Kumasi Center for Collaborative Research (KCCR) in Tropical Medicine, KNUST, for assistance with blood separation and shipping of samples. This research was supported by USAID grant LAG-G-00-96-90013-00 for the Peanut Collaborative Support Research Program and Minority Health International Research Training (MHIRT) grant number MD001448-09 from the National Center on Minority Health and Health Disparities, National Institutes of Health, USA.