Aflatoxin exposure in viral hepatitis b adults in Ghana

The consumption of foodstuffs contaminated with aflatoxins may lead to hepatotoxic effect particularly in coexistence with chronic viral hepatitis B 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 B infection in Ghana. The study was conducted in the Ejura-Sekyedumase district, Ghana. Five hundred adults were screened for viral hepatitis B surface antigen. Spot urine and blood samples were collected. Analysis of AFM1 in the urine were measured using immunoaffinity column purification (AflaTest) followed by HPLC-fluorescence detection. Viral hepatitis B surface antigen and liver damage markers were detected using Clinogen rapid kit and automated calorimetric method respectively in the blood samples. Out of total number of 500 samples screened, only 43(8.6%) tested positive for HBsAg whiles 457 (91.4%) tested negative. Forty three controls (HBsAg negative) were selected. 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 GGT concentrations between the Hepatitis B surface antigen positive and their control group. Four adults (9.3%) tested positive for HBeAg with mean concentration of AFM1, ALT and AST of 6107.1 pg/dL 56.7 U/L and 78.8U/L respectively. Results from our study have 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.