Exposure to aflatoxin B(1) and associated risk factors in hepatitis C patients in cosmopolitan city of Pakistan: facility-based study

INTRODUCTION: population-based follow-up study has been designed to investigate the contributing factors to high exposure to Aflatoxin B(1) (AFB(1)) and the subsequent associated risk factors among hepatitis C-infected patients at a referral centre, Karachi. Pakistan. Hepatitis C infection affects millions of individuals worldwide and confers high morbidity and mortality, especially in lower middle-income countries (LMICs) including Pakistan. A literature review of recent studies has revealed that a number of hepatocellular carcinomas (HCC) cases are markedly increased in Pakistan, where one of the potential causes of HCC is hepatitis C virus. The objectives of this study were to determine frequency of Aflatoxin B(1) (AFB(1)) exposure and other associated characteristics among hepatitis C patients at a referral centre, Karachi, Pakistan. METHODS: a semi-structured pre-coded pro forma designed to collect socio-demographic, Pharmacological, biochemical and clinical information from patients and hospital records. Patient´s pre and post polymerase chain reaction (PCR), serum alanine aminotransferase (ALT) levels and other blood parameters were analysed. AFB(1) exposure was determined using an ELISA kit and validated through high-performance liquid chromatography (HPLC). RESULTS: AFB(1) exposure was found in 30 (34%) patients. Post treatment responders were 49 (55.6%). More than 37% of study participants had a family history of hepatitis C. About 74% had a history of surgical procedure, and around 36% of study participants had a blood transfusion history. Up to 36% participants were fond of spicy food and around 25% study participants were eating roadside food on daily basis. CONCLUSION: high frequency of AFB(1) exposure due to risky dietary habits, low level of formal education and awareness are contributing factors may be responsible for high exposure of AFB(1). Effective and multidimensional strategies are needed to prevent advance stage progression of disease and associated complications.