Role of Aflatoxin B1 as a risk for primary liver cancer in north Indian population

ObjectivesThe present study was designed to determine whether aflatoxin B1 (AFB1) exposure has any role to play in hepatocellular carcinoma (HCC) patients from northern India.Design and methodsA total of 266 HCC patients and 251 patients of chronic liver disease without-HCC were enrolled into the study. All samples were screened for serological markers for hepatitis B and C infections and levels of AFB1 in food and urine samples.ResultsA threefold (OR = 3.43) and five-fold (OR = 5.47) increased risk of HCC was observed amongst HBV infection and AFB1-levels in food and urine samples, respectively. However, a non-significant risk was observed with respect to HCV infection (OR = 1.27) and alcohol consumption (OR = 1.18). A threefold (OR = 3.15) increased risk of HCC was observed amongst cases of non-viral etiology with respect to urinary AFB1.ConclusionThe data provides an exposure and disease risk information for establishing intervention studies to diminish the impact of aflatoxin exposure in Indian population.

► The infection with hepatitis B was prevalent among HCC cases and control followed by HCV infection.
► A significant risk was observed for higher dose of alcohol consumption, ( > 100 g/day) with HCC patients.
► A significant positive association was observed between AFB1 exposure, measured as dietary AFB1 levels and urinary AFB1 metabolites, and risk of HCC.
► A synergistic interaction between HBV infection and AFB1 exposure on HCC risk was observed.
► The effect of combined AFB1 exposure and HBV infection is more consistent with an additive effect in our population.