Hepatitis B infection and aflatoxin biomarker levels in Gambian children

OBJECTIVES To examine the relationship between hepatitis B virus (HBV) infe ction and biomarkers of aflatoxin exposure in West African children. METHODS Sera from 444 children aged 3-4 years who were selected to be repre sentative of their communities were analysed for aflatoxin-albumin (AF-alb) adducts and markers of hepatitis B infection. RESULTS There was large interindividual variation in adduct levels (range: 2.2 to 459 pg AF-lysine eq./mg albumin). Adduct level was strongly correlat ed with season, with an approximately twofold higher mean level in the dry season than the wet. Geometric mean adduct levels in uninfected children, c hronic carriers and acutely infected children were 31.6 (n = 404), 44.9 (n = 34) and 96.9 (n = 6) pg/mg, respectively. The relationship of AF -alb lev el to ethnicity, month of sampling and HBV status was examined in a multipl e regression model. Month of obtaining the blood sample (P=0.0001) and HBV status (P=0.0023) each made a highly significant contribution to the model; the high AF-alb levels were particularly associated with acute infection. Elevated serum transaminase levels were significantly (P<0.002) associated with HBV status, with acutely infected children having the highest levels. Ethnicity was not significantly associated with AF-alb adduct levels in the model (P=0.09). CONCLUSIONS. HBV infection and month of sampling both significantly influen ce AF-alb adduct levels. The effect of seasonality on adducts was also obse rved in a previous study of 347 Gambian adults, although there was no corre lation between adduct level and HBV status in that population. This differe nce between children and adults may reflect a more severe effect of HBV inf ection, particularly acute infection, in childhood on hepatic AF metabolism .