Aflatoxin B1 exposure increases the risk of cirrhosis and hepatocellular carcinoma in chronic hepatitis B virus carriers. Issue 4 (26th May 2017)

• Record Type: Journal Article
• Authors: Chu, Yu‐Ju; Yang, Hwai‐I; Wu, Hui‐Chen; Liu, Jessica; Wang, Li‐Yu; Lu, Sheng‐Nan; Lee, Mei‐Hsuan; Jen, Chin‐Lan; You, San‐Lin; Santella, Regina M.; Chen, Chien‐Jen
• Is Part Of: International journal of cancer. Volume 141:Issue 4(2017:Aug. 15)
• Page Start: 711
• Page End: 720
• Publication Date: 2017-05-26
• Subjects: aflatoxin B1‐albumin adducts -- cirrhosis -- HCC -- chronic hepatitis B; Cancer -- Periodicals; Cancer -- Prevention -- Periodicals; 616.994
• DOI: 10.1002/ijc.30782
• Languages: English
• ISSNs: 0020-7136

Abstract

Abstract : The relation between aflatoxin B1 (AFB1 ) and cirrhosis in chronic carriers of hepatitis B virus (HBV) remains inconclusive. This case‐control study nested in a large community‐based cohort aimed to assess the effect of AFB1 exposure on cirrhosis and HCC in chronic HBV carriers. Serum AFB1 ‐albumin adduct levels at study entry were measured in 232 cirrhosis cases, 262 HCC cases and 577 controls. Multivariate‐adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) were estimated using logistic regression. Among all chronic HBV carriers, the time intervals between study entry and diagnosis of HCC, cirrhosis, cirrhotic HCC, and non‐cirrhotic HCC were all significantly ( p < 0.0001) shorter in participants with high serum levels of AFB1 ‐albumin adducts than those with low/undetectable levels. There were significant dose‐response relations with serum AFB1 ‐albumin adduct level at study entry for cirrhosis ( p ‐trend = 0.0001) and cirrhotic HCC ( p ‐trend < 0.0001) newly diagnosed within 9 years after entry as well as non‐cirrhotic HCC ( p ‐trend = 0.021) newly diagnosed within 4 years after entry. The aORs (95% CIs) for high versus undetectable serum AFB1 ‐albumin adduct levels were 2.45 (1.51–3.98) for cirrhosis ( p = 0.0003), 5.47 (2.20–13.63) for cirrhotic HCC ( p = 0.0003), and 5.39 (1.11–26.18) for non‐cirrhotic ( p = 0.0368) HCC, respectively. There remained a significant dose‐response relation between serum AFB1 ‐albumin adduct level and HCC risk ( p ‐trend = 0.0291) in cirrhosis patients, showing an aOR (95% CI) of 3.04 (1.11–8.30) for high versus undetectable serum levels ( p = 0.0299). It is concluded that AFB1 exposure may increase the risk of cirrhosis and HCC in a dose‐response manner among chronic HBV carriers. Abstract : What's new? Aflatoxin B1 (AFB1 ), a potent carcinogen produced by fungi, is the most abundant aflatoxin found in contaminated food. Here, the authors examined its association with liver cirrhosis risk. Using an ELISA to measure AFB1 ‐albumin adducts in the blood, they found that AFB1 exposure increases the risk of developing cirrhosis and liver cancer, and may also accelerate the progression of chronic hepatitis B virus infection to both conditions. They conclude that AFB1 may not only contribute to hepatocarcinogenesis directly, but also indirectly by rendering liver cells more vulnerable by promoting cirrhosis.