Aflatoxin exposure and viral hepatitis in the etiology of liver cirrhosis in the Gambia, West Africa.
Aflatoxin exposure and viral hepatitis in the etiology of liver cirrhosis in the Gambia, West Africa.
复制标题
DOI：
10.1289/ehp.11661
复制
发表时间：
2008-11
影响因子：
10.4
通讯作者：
Kirk GD
中科院分区：
文献类型：
--
作者：
Kuniholm MH;Lesi OA;Mendy M;Akano AO;Sam O;Hall AJ;Whittle H;Bah E;Goedert JJ;Hainaut P;Kirk GD
肝硬化被认为是撒哈拉以南非洲地区发病和死亡的主要原因，但在该地区很少有关于肝硬化病因的对照研究。我们的目的是阐明环境和传染性暴露与冈比亚肝硬化之间的关系。使用有效的超声评分系统诊断出97人患有肝硬化，并与397名对照组进行比较。参与者报告了人口统计和食物频率信息。检测血样中乙型肝炎表面抗原（HBsAg）、乙型肝炎e抗原（HBeAg）、丙型肝炎病毒（HCV）抗体、HCV RNA和黄曲霉毒素相关的249ser TP53突变。HBsAg血清阳性与肝硬化风险显著增加相关[优势比(OR) = 8.0；HBeAg （OR = 10.3; 95% CI, 2.0-53.9）和HCV感染（OR = 3.3; 95% CI, 1.2-9.5）的存在也是如此。我们提出了新的数据，通过长期食用花生（花生）和血浆中存在249ser TP53突变来评估黄曲霉毒素暴露与肝硬化风险的显著增加有关（OR = 2.8； 95% CI分别为1.1-7.7和3.8；95% CI分别为1.5-9.6）。此外，黄曲霉毒素和乙型肝炎病毒暴露似乎协同作用，大大增加肝硬化的风险，尽管这没有统计学意义。我们的结果表明，与黄曲霉毒素暴露相关的发病率谱可能包括肝硬化。
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. We aimed to elucidate the association between environmental and infectious exposures and cirrhosis in The Gambia. 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 249ser TP53 mutation. 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 249ser 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. Our results suggest that the spectrum of morbidity associated with aflatoxin exposure could include cirrhosis.
登录
查看更多内容
影响因子：
120.7
作者：
Chen, CJ;Yang, HI;Iloeje, UH
通讯作者：
Iloeje, UH
影响因子：
13.5
作者：
Kirk, GD;Lesi, OA;Montesano, R
通讯作者：
Montesano, R
影响因子：
56.9
作者：
AGUILAR, F;HARRIS, CC;CERUTTI, P
通讯作者：
CERUTTI, P
影响因子：
29.4
作者：
Iloeje, UH;Yang, HI;Chen, CJ
通讯作者：
Chen, CJ
影响因子：
8
作者：
Kirk, GD;Lesi, OA;Montesano, R
通讯作者：
Montesano, R