Aflatoxin Exposure and Viral Hepatitis in the Etiology of Liver Cirrhosis in The Gambia, West Africa
نویسندگان
چکیده
BACKGROUND Cirrhosis of the liver is thought to be a major cause of morbidity and mortality in sub-Saharan Africa, but few controlled studies on the etiology of cirrhosis have been conducted in this region. OBJECTIVES We aimed to elucidate the association between environmental and infectious exposures and cirrhosis in The Gambia. METHODS Ninety-seven individuals were diagnosed with cirrhosis using a validated ultrasound scoring system and were compared with 397 controls. Participants reported demographic and food frequency information. Blood samples were tested for hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg), hepatitis C virus (HCV) antibody, HCV RNA, and the aflatoxin-associated 249(ser) TP53 mutation. RESULTS HBsAg seropositivity was associated with a significant increase in risk of cirrhosis [odds ratio (OR) = 8.0; 95% confidence interval (CI), 4.4-14.7] as was the presence of HBeAg (OR = 10.3; 95% CI, 2.0-53.9) and HCV infection (OR = 3.3; 95% CI, 1.2-9.5). We present novel data that exposure to aflatoxin, as assessed both by high lifetime groundnut (peanut) intake and by the presence of the 249(ser) TP53 mutation in plasma, is associated with a significant increase in the risk for cirrhosis (OR = 2.8; 95% CI, 1.1-7.7 and OR = 3.8; 95% CI, 1.5-9.6, respectively). Additionally, aflatoxin and hepatitis B virus exposure appeared to interact synergistically to substantially increase the risk of cirrhosis, although this was not statistically significant. CONCLUSIONS Our results suggest that the spectrum of morbidity associated with aflatoxin exposure could include cirrhosis.
منابع مشابه
نقش هپاتیت ب در ایجاد سیروزکبدی در 170 بیمار بستری در بیمارستان حضرت رسول اکرم(ص) طی سالهای 1371- 1360
In order to evaluate the pathogenic role of viral hepatitis in liver cirrhosis, a retrospective study was carried out in 170 patients with cirrhosis of liver who were admitted in Rasool-Akram hospital between the years 1360-1371. The cause of cirrhosis was unknown in 67.1 % and in others with known etiology, hepatitis B and hepatitis C were causes of cirrhosis in 22.4 % and 3 % respectively. Th...
متن کاملGut Microbiota and Chronic Hepatitis B and C Viruses-Induced Cirrhosis
Hepatitis B and C viruses are major public health problems. These viruses can chronically lead to liver disease such as fibrosis, cirrhosis, and hepatocellular carcinoma, which often increase mortality in these patients. According to previous studies, the liver is highly affected by changes in the microbiota of gastrointestinal tract and immune system damage caused by inflammation due to viral ...
متن کاملAge at Establishment of Chronic Hepatitis B Infection as a Risk Factor for Persistent Viral Replication, Liver Fibrosis and Hepatocellular Carcinoma in The Gambia, West Africa
متن کامل
Hepatitis B viral load and risk for liver cirrhosis and hepatocellular carcinoma in The Gambia, West Africa
The main objectives of this study were to define the occurrence and levels of hepatitis B virus (HBV) DNA in asymptomatic HBV carriers, cirrhosis patients and hepatocellular carcinoma (HCC) cases from The Gambia, and to evaluate the risk for cirrhosis or HCC associated with HBV viremia. We used sensitive real-time quantitative PCR assays to measure HBV DNA in samples from a case-control study c...
متن کاملHepatitis B and Hepatitis C in large vehicle drivers in center of Iran (Yazd)
Introduction: Hepatitis B and C are major health problems in many countries, especially developing areas. The frequency of hepatitis B is less than 0.8%, and chronic hepatitis C is less than 0.5% in the general population of Yazd in the center of Iran. Large vehicle drivers have some risk factors for acquiring hepatitis B and C infection. This is important because viral hepatitis complications,...
متن کامل