Abstract:
BACKGROUND:Cirrhosis of the liver is thought to be a major cause of morbidity and mortality in sub-Saharan Africa, but few controlled studies on the etiology of cirrhosis have been conducted in this region. OBJECTIVES:We aimed to elucidate the association between environmental and infectious exposures and cirrhosis in The Gambia. METHODS:Ninety-seven individuals were diagnosed with cirrhosis using a validated ultrasound scoring system and were compared with 397 controls. Participants reported demographic and food frequency information. Blood samples were tested for hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg), hepatitis C virus (HCV) antibody, HCV RNA, and the aflatoxin-associated 249(ser) TP53 mutation. RESULTS:HBsAg seropositivity was associated with a significant increase in risk of cirrhosis [odds ratio (OR) = 8.0; 95% confidence interval (CI), 4.4-14.7] as was the presence of HBeAg (OR = 10.3; 95% CI, 2.0-53.9) and HCV infection (OR = 3.3; 95% CI, 1.2-9.5). We present novel data that exposure to aflatoxin, as assessed both by high lifetime groundnut (peanut) intake and by the presence of the 249(ser) TP53 mutation in plasma, is associated with a significant increase in the risk for cirrhosis (OR = 2.8; 95% CI, 1.1-7.7 and OR = 3.8; 95% CI, 1.5-9.6, respectively). Additionally, aflatoxin and hepatitis B virus exposure appeared to interact synergistically to substantially increase the risk of cirrhosis, although this was not statistically significant. CONCLUSIONS:Our results suggest that the spectrum of morbidity associated with aflatoxin exposure could include cirrhosis.
journal_name
Environ Health Perspectjournal_title
Environmental health perspectivesauthors
Kuniholm MH,Lesi OA,Mendy M,Akano AO,Sam O,Hall AJ,Whittle H,Bah E,Goedert JJ,Hainaut P,Kirk GDdoi
10.1289/ehp.11661subject
Has Abstractpub_date
2008-11-01 00:00:00pages
1553-7issue
11eissn
0091-6765issn
1552-9924journal_volume
116pub_type
杂志文章abstract::The normal mucociliary epithelium of the respiratory tract in chronic cigarette smokers often is replaced focally by a metaplastic squamous epithelium. Because asbestos workers who smoke have a substantially greater risk of bronchogenic carcinoma than nonsmokers, we hypothesized that interaction of asbestos with squam...
journal_title:Environmental health perspectives
pub_type: 杂志文章
doi:10.1289/ehp.835127
更新日期:1983-09-01 00:00:00
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journal_title:Environmental health perspectives
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journal_title:Environmental health perspectives
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journal_title:Environmental health perspectives
pub_type: 杂志文章
doi:10.1289/ehp.94102s6209
更新日期:1994-10-01 00:00:00
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journal_title:Environmental health perspectives
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journal_title:Environmental health perspectives
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journal_title:Environmental health perspectives
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更新日期:2006-01-01 00:00:00
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journal_title:Environmental health perspectives
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更新日期:1990-07-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2011-03-01 00:00:00
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pub_type: 共识发展会议,杂志文章,评审
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更新日期:1994-12-01 00:00:00
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journal_title:Environmental health perspectives
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journal_title:Environmental health perspectives
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更新日期:1993-12-01 00:00:00
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journal_title:Environmental health perspectives
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journal_title:Environmental health perspectives
pub_type: 杂志文章,评审
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更新日期:1998-02-01 00:00:00