Evaluating human exposure to aflatoxins: A case study on aflatoxinalbumin adduct levels in end stage liver disease patients in India

Aflatoxin B1, a secondary metabolite of Aspergillus flavus and A. parasiticus, is a frequent contaminant of several food crops. The main objective of this study was to know the effect of post exposure of aflatoxin in humans through consumption of contaminated foods. The aflatoxin-albumin level of selected human populations in India were analysed. A total of 673 blood samples were further analyzed by Indirect competitive Enzyme linked immunosorbent assay (IC-ELISA) method. The samples were collected along with clinical profile, demographic and food consumption data from the individuals with different stages of liver disease. The severity of the liver disease was calculated based on the “Model for End stage Liver Disesae” (MELD) score. The results indicated 86 of 673 samples have concentration of aflatoxin-albumin adduct ranged between 2.5 to 677 pg mg-1 of albumin with mean adduct level 181.9 ±5 and SD 1.49 ± 7. At 5% level of significance pb value 0.039 (<0.05) indicates presence of aflatoxin B1-lysine adducts and hepatitis B has synergistic effect on liver damage especially in end stage liver disease based on model for end stage liver disease (MELD). This shows that there is considerable intake of aflatoxin through contaminated food. Interestingly the concentration of aflatoxin-albumin was high and this along with the HBV positivity was found to be contributing to the severity of liver disease and lead to decompensated liver disease.