ArticlePloS one2017
Aflatoxin and viral hepatitis exposures in Guatemala: Molecular biomarkers reveal a unique profile of risk factors in a region of high liver cancer incidence.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 1 of them a synthesis that pooled it.
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Who cites it
38 citing papers in PubMed, 1 synthesis or guideline pooled it, 67 citations in OpenAlex.
- Human Biomonitoring of Mycotoxins in Blood, Plasma and Serum in Recent Years: A Review.Toxins · 2020Pooled it
- Aflatoxin BJournal of fungi (Basel, Switzerland) · 2026Article
- Review
- Article
- Aflatoxin exposure and mortality in acutely ill children: results from the CHAIN network cohort.BMJ global health · 2025Article
- Environmental risk factors for liver cancer.Hepatology (Baltimore, Md.) · 2025Article
- Higher plasma AFB1 concentration is associated with increased risk of HPV 16 and HPV 18 detection and persistence among Ugandan women.Environmental health : a global access science source · 2025Article
- High Seroprevalence ofGastroenterology research · 2025Article
- Identification and exploration of anticancer activity of novel peptides isolated from the edible bivalveToxicology reports · 2025Article
- Dietary, socioeconomic, and maize handling practices associated with aflatoxin and fumonisin exposure among women tortilla makers in 5 departments in Guatemala.PLOS global public health · 2024Article
- Aflatoxin exposure in adults in southern and eastern Mexico in 2018: A descriptive study.International journal of hygiene and environmental health · 2023Article
- Association of plasma aflatoxin with persistent detection of oncogenic human papillomaviruses in cervical samples from Kenyan women enrolled in a longitudinal study.BMC infectious diseases · 2023Article
- Assessment of aflatoxin exposure, growth faltering and the gut microbiome among children in rural Guatemala: protocol for an observational prospective cohort and bioreactor simulations.BMJ paediatrics open · 2023Article
- The Potential Inhibitory Role of Acetyl-L-Carnitine on Proliferation, Migration, and Gene Expression in HepG2 and HT29 Human Adenocarcinoma Cell Lines.Current issues in molecular biology · 2023Article
- Association of Plasma Aflatoxin With Persistent Detection of Oncogenic Human Papillomaviruses in Cervical Samples From Kenyan Women Enrolled in a Longitudinal Study.Research square · 2023Article
- Circulating bile acid concentrations and non-alcoholic fatty liver disease in Guatemala.Alimentary pharmacology & therapeutics · 2022Article
- Liver cancer mortality in Mexico: trend analysis from 1998 to 2018.Salud publica de Mexico · 2022Article
- Aflatoxin levels and prevalence of TP53 aflatoxin-mutations in hepatocellular carcinomas in Mexico.Salud publica de Mexico · 2022Article
- Assessing the Validity of Normalizing Aflatoxin BToxins · 2022Article
- Associations between aflatoxin BHealth science reports · 2022Article
Corrections and comments
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Authors and funding
12 authors at 4 institutions in 3 countries.
Funding
Abstract
Liver cancer is an emerging global health issue, with rising incidence in both the United States and the economically developing world. Although Guatemala experiences the highest rates of this disease in the Western hemisphere and a unique 1:1 distribution in men and women, few studies have focused on this population. Thus, we determined the prevalence and correlates of aflatoxin B1 (AFB1) exposure and hepatitis virus infection in Guatemalan adults. Healthy men and women aged ≥40 years (n = 461), residing in five departments of Guatemala, were enrolled in a cross-sectional study from May-October of 2016. Serum AFB1-albumin adducts were quantified using isotope dilution mass spectrometry. Multivariate linear regression was used to assess relationships between AFB1-albumin adduct levels and demographic factors. Biomarkers of hepatitis B virus and hepatitis C virus infection were assessed by immunoassay and analyzed by Fisher's exact test. AFB1-albumin adducts were detected in 100% of participants, with a median of 8.4 pg/mg albumin (range, 0.2-814.8). Exposure was significantly higher (p<0.05) in male, rural, low-income, and less-educated participants than in female, urban, and higher socioeconomic status participants. Hepatitis B and C seropositivity was low (0.9% and 0.5%, respectively). Substantial AFB1 exposure exists in Guatemalan adults, concurrent with low prevalence of hepatitis virus seropositivity. Quantitatively, AFB1 exposures are similar to those previously found to increase risk for liver cancer in Asia and Africa. Mitigation of AFB1 exposure may reduce liver cancer incidence and mortality in Guatemala, warranting further investigation.
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