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Aflatoxin and viral hepatitis exposures in Guatemala: Molecular biomarkers reveal a unique profile of risk factors in a region of high liver cancer incidence
Journal article   Open access   Peer reviewed

Aflatoxin and viral hepatitis exposures in Guatemala: Molecular biomarkers reveal a unique profile of risk factors in a region of high liver cancer incidence

Joshua W Smith, Maria F Kroker-Lobos, Mariana Lazo, Alvaro Rivera-Andrade, Patricia A Egner, Heiner Wedemeyer, Olga Torres, Neal D Freedman, Katherine A McGlynn, Eliseo Guallar, …
PloS one, v 12(12), pp e0189255-e0189255
13 Dec 2017
PMID: 29236788
url
https://doi.org/10.1371/journal.pone.0189255View
Published, Version of Record (VoR) Open

Abstract

Adult Aflatoxin B1 - blood Aflatoxin B1 - toxicity Aflatoxins - blood Aged Aged, 80 and over Albumins Cross-Sectional Studies Environmental Exposure Female Guatemala - epidemiology Hepatitis B - complications Hepatitis B - epidemiology Hepatitis C - complications Hepatitis C - epidemiology Humans Incidence Liver Neoplasms - complications Liver Neoplasms - epidemiology Male Middle Aged Risk Factors
Liver cancer is an emerging global health issue, with rising incidence in both the United States and the economically developing world. Although Guatemala experiences the highest rates of this disease in the Western hemisphere and a unique 1:1 distribution in men and women, few studies have focused on this population. Thus, we determined the prevalence and correlates of aflatoxin B1 (AFB1) exposure and hepatitis virus infection in Guatemalan adults. Healthy men and women aged ≥40 years (n = 461), residing in five departments of Guatemala, were enrolled in a cross-sectional study from May-October of 2016. Serum AFB1-albumin adducts were quantified using isotope dilution mass spectrometry. Multivariate linear regression was used to assess relationships between AFB1-albumin adduct levels and demographic factors. Biomarkers of hepatitis B virus and hepatitis C virus infection were assessed by immunoassay and analyzed by Fisher's exact test. AFB1-albumin adducts were detected in 100% of participants, with a median of 8.4 pg/mg albumin (range, 0.2-814.8). Exposure was significantly higher (p<0.05) in male, rural, low-income, and less-educated participants than in female, urban, and higher socioeconomic status participants. Hepatitis B and C seropositivity was low (0.9% and 0.5%, respectively). Substantial AFB1 exposure exists in Guatemalan adults, concurrent with low prevalence of hepatitis virus seropositivity. Quantitatively, AFB1 exposures are similar to those previously found to increase risk for liver cancer in Asia and Africa. Mitigation of AFB1 exposure may reduce liver cancer incidence and mortality in Guatemala, warranting further investigation.

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Domestic collaboration
International collaboration
Web of Science research areas
Oncology
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