Serum aflatoxin level as a predictor of hepatocarcinogenesis in HCV-infected Egyptians

ABSTRACT

Egypt has a very high prevalence of Hepatitis virus type C [HCV] infection and an increasing incidence of hepatocellular carcinoma [HCC] in a younger age group. As alcoholism is rare in Egypt, the main risk factor for carcinogenesis in HCV infected patients is supposed to be mutation induced by aflatoxin or its metabolites in hepatocytes. The environmental exposure to aflatoxins in foods or feeds may be reflected on the level of circulating aflatoxin [AFB1] in blood. The levels of albumin-abducted AFB1 were measured using a quantitative ELISA test in the sera of 80 Egyptian patients diagnosed as HCC, 40 HCV infected non malignant subjects and 40 healthy control individuals. The mean value of albumin-abducted AFB1 in the sera of HCC patients was significantly higher than the control groups [P< 0.05]. Farmers coming from rural areas had significant rise in the AFB1 compared to other patients coming from urban areas or having other jobs [P< 0.01]. The level of AFB1 was noticed to be significantly higher in patients having multiple lesions and also in patients presenting with tumor sizes more than 5 cm [P< 0.05]. HCV antibody and/or RNA were detected in all examined HCC patients. Exposure to environmental aflatoxin seems to be a major risk factor for HCC in HCV-infected Egyptians. HCV chronic hepatitis could render the liver less capable of intoxication and removal of AFB1 from the body. Then the accumulated AFB1 may induce mutation in p53 paving the way for HCV to induce HCC