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Aflatoxin Exposure and Hepatitis C Virus in Advanced Liver Disease in a Hepatitis C Virus–Endemic Area in Taiwan

This community-based study evaluated the role of aflatoxin exposure in advanced liver disease in hepatitis C virus (HCV)-endemic townships. Preventive health examination was performed on 314 adults 40 years of age recruited from HCV-endemic townships in Tainan, Taiwan. Aflatoxin-albumin in serum was quantified by a new enzyme-linked immunosorbent assay method. After adjusting serum albumin levels and platelet counts, aflatoxin-Bi albumin adducts was still an independent risk factor for advanced liver disease among all 314 residents (> 8 versus 8 (AFBi)-albumin/albumin; OR = 2.29, 95% CI = 1.23–4.27, P = 0.009) and particularly in anti-HCV-positive subjects (OR = 2.09, 95% CI = 1.09–4.0, P = 0.026). Levels of AFB1-albumin/albumin were significantly related to ultrasonographic parenchyma scores (P < 0.001, one-way ANOVA) in all and anti-HCV–positive subjects. The findings indicated aflatoxin exposure may be associated with advanced liver disease in chronic hepatitis C patients in HCV-endemic regions in Taiwan.

Received February 20, 2007. Accepted for publication July 27, 2007.

Financial support: This study was supported by Grant NSC92-2314-B182A-046 from the National Council of Science, Taiwan.

^* Address correspondence to Sheng-Nan Lu, Department of Internal Medicine, 123 Tapei Road, Niaosung 833, Kaohsiung, Taiwan. E-mail: juten{at}ms17.hinet.net

Authors’ addresses: Chien-Hung Chen, Jing-Houng Wang, Chao-Hung Hung, Tsung-Hui Hu, Chuan-Mo Lee, Chi-Sin Changchien, Pao-Fei Chen, Mei-Chin Hsu, and Sheng-Nan Lu, Division of Hepato-Gastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital, 123 Ta Pei Road, Kaohsiung 833, Taiwan. Mei-Hui Wang and Shui-Cheng Lee, Institute of Nuclear Energy Research, Energy Council, Executive Yuan, Taoyuan, Taiwan. Hung-Da Tung, Division of Gastroenteroloy, Department of Internal Medicine, Chi Mei Hospital Liuying Branch, Tainan, Taiwan.

Reprint requests: Sheng-Nan Lu, Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, 123 Ta Pei Road, Kaohsiung 833, Taiwan, Telephone: 886-7-7317123, extension 8301, Fax: 886-7-7322402, E-mail: juten{at}ms17.hinet.net.