Aflatoxin Levels in Adults with Viral Hepatitis Infection In The Ejura-Sekyedumase District of Ghana

Abstract

The consumption of foodstuffs contaminated with aflatoxins may lead to hepatotoxic effect particularly in coexistence with chronic viral hepatitis infection. In Sub-Saharan Africa, hepatocellular carcinoma is one of the most common malignancies. The aim of this study was to measure the level of exposure of aflatoxin and liver damage markers in adults with viral hepatitis in Ghana. The study was conducted in the Ejura-Sekyedumase district, Ghana. Five hundred adults were screened for viral hepatitis B and C. Spot urine and blood were collected and analysis of AFM1 in the urine was measured using immunoaffinity column purification (AflaTest) followed by HPLC-flourescence detection at wavelength of 365 nm excitation and 425 nm emission . Viral hepatitis B and C and liver damage markers were measured from the blood serum samples using an automated colorimetric method. Out of total number of 500 samples screened 43(8.6%) tested positive for HBsAg only whiles 457 (91.4%) tested negative. Twelve samples tested positive for HCV. Fifty five samples tested negative for HBsAg and HCV for which were used as controls. There was significant difference in the AFM1 levels between the HBsAg positive adults (5255.0±2757.9) and their controls (374.8± 227.7) (P=0.001). There was no significant difference in the ALT, AST, and albumin concentrations between the Hepatitis B surface antigen positive adults and the control group. Four adults (9.3%) tested positive for HBeAg with mean±SD concentration of AFM1, ALT and AST of 6536.7±5558.5 pg/dL, 58.0±12.4 U/L and 78.8±55.8 U/L respectively. Results from this study demonstrated significant levels of aflatoxin in HBsAg positive subjects compared to HBsAg negative subjects. The observations emphasize the need for aflatoxin exposure intervention strategies in high-risk countries; possibly targeted at postharvest food handling.