1 research outputs found
Environmental Microcystin Exposure Increases Liver Injury Risk Induced by Hepatitis B Virus Combined with Aflatoxin: A Cross-Sectional Study in Southwest China
Three liver hazards,
two confirmedî—¸hepatitis B virus (HBV)
and aflatoxin (AFB), and one rarely studied in populationsî—¸microcystin
(MC), simultaneously exist in tropical and humid areas; however, there
are no epidemiological data on their risks in the same population.
We conducted a community-based cross-sectional survey among 5493 adults
in two rural towns and statistically analyzed the comparative and
combinative effects of the three factors after detecting HBsAg and
HBV DNA titers, determining estimated daily intakes (EDIs) of AFB1
and MC-LR and testing serum AST and ALT as liver injury markers for
each participant. We observed a HBsAgÂ(+) rate of 7.6%, a relatively
high AFB1 exposure level (mean EDI<sub>AFB1</sub> = 471.30 ng/d),
and a relatively low MC-LR exposure level (mean EDI<sub>MC‑LR</sub> = 228.25 ng/d). ORs for abnormal AST (2.42, 95%CI = 1.69–3.45)
and ALT (2.87, 95%CI = 1.91–4.29) increased in HBV infections
compared with HBV-unexposed participants but did not increase in participants
with separate or combined exposure to AFB1 and MC-LR (EDIs ≥
mean). Meanwhile, after adjustment for confounding factors, means
of AST and ALT and ORs of abnormal AST and ALT were successively elevated
after exposure to HBV, HBV&AFB1 (or HBV&MC-LR), and HBV&AFB1&MC-LR,
especially in the group with detectable HBV DNA (AST: OR = 11.38,
95%CI = 3.91–33.17; ALT: OR = 17.09, 95%CI = 5.36–54.53).
Notably, ORs for abnormal AST and ALT in the HBV exposed group were
not significantly different from those in HBV&AFB1 or in the HBV&MC-LR
exposed group but were significantly higher in the HBV&AFB1&MC-LR
exposed group (<i>P</i> = 0.029 and <i>P</i> =
0.037, respectively). Our study indicated that microcystin may have
the potential to increase the risk of liver injury induced by combined
exposure to HBV and aflatoxin. However, in consideration of the uncertainties
in the detection of the toxins and evaluation of the EDIs, more epidemiological
data are expected to determine the increasing toxic effects of microcystins