Aflatoxin B1 exposure and the risk of hepatocellular carcinoma in Iranian carriers of viral hepatitis B and C

Hepatocellular carcinoma (HCC) is known as one of the common and fatal cancers in the Asian and African countries. Two significant factors could cause this type of cancer including having diets contaminated with aflatoxin and chronic viral hepatitis infections. This study aimed to compare the level of aflatoxin B-1 (AFB(1)) in those who had viral hepatitis B- and C-related HCC as a case group and a group of patients with chronic hepatitis B or C infections as the control group. This case-control study was conducted on 82 patients including 41 patients with viral hepatitis-related HCC and 41 patients with chronic hepatitis B or C infections. Level of AFB(1) was measured using ELISA and compared between groups. Most of the patients in both groups were male and infected with HBV. The patients with HCC with mean age 57.5 years were significantly older than those in the control group with mean age 44.8 years (p < .05). Aflatoxin B-1 was detected in 32 (78%) samples in HCC group and 28 (68.3%) samples in non-HCC group (p > .05). The median (IQR) for AFB(1) levels in HCC group was 3.87 (3.46) pg/mL, while it was 2.63 (3.14) pg/mL in the control group (p = .018). Our results demonstrate for the first time the exposure to high levels of AFB(1) in Iranian patients with HCC which indicate the possible involvement of AFB(1) as a major risk factor in the etiology of HCC in patients with hepatitis B and C.