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Please use this identifier to cite or link to this item: http://hdl.handle.net/123456789/9676

Title: HIV and hepatocellular and esophageal carcinomas related to consumption of mycotoxin-prone foods in sub-Saharan Africa.
Authors: Phillips, T.D.
Robinson, A.G.
Johnson, N.M.
Afriyie-Gyawu, E.
Ellis, William Otoo
Ankrah, N.A.
Jolly, P.E.
Wang, J.S.
Davis, J.W.
Grubb, J.A.
Williams, J.H.
Issue Date: 19-May-2010
Publisher: The American Journal of Clinical Nutrition
Citation: The American Journal of Clinical Nutrition 2010 Jul;92(1):154-60. doi: 10.3945/ajcn.2009.28761. Epub 2010 May 19.
Abstract: Promotion of the HIV epidemic by aflatoxin is postulated but not yet established. Sub-Saharan populations commonly consume food contaminated by mycotoxins, particularly aflatoxins (predominantly found in peanut, maize, rice, and cassava) and fumonisins, which occur primarily in maize. Aflatoxin promotes hepatocellular cancer, and fumonisin may promote esophageal cancer. Objectives: This analysis was undertaken to test the hypotheses that consumption of mycotoxin-prone staple foods is 1) related to the incidence of HIV infection in Africa and 2) related to “signature” cancer rates confirming exposure to aflatoxins and fumonisins. World Health Organization data for causes of death and the Food and Agriculture Organization per capita consumption data for commodities in sub-Saharan Africa were used. Per capita Gross Domestic Product and the percentage of Muslims (%Muslim) were the socioeconomic data sets exploited. Relations between causes of mortality, consumption of mycotoxin-prone foods, and socioeconomic variables were evaluated. Models for HIV transmission as a function of maize consumption and %Muslim were estimated. Results: HIV and esophageal cancer deaths were significantly related to maize but were inversely related to %Muslim and rice consumption. HIV infections were minimized (74 compared with 435/100,000 people; odds ratio: 2.41; 95% CI: 1.73, 3.24; P 0.0001) by the combination of low maize consumption and above-median %Muslim. Hepatocellular cancer deaths were positively related to rice but negatively related to maize consumption. Conclusions: HIV transmission frequency is positively associated with maize consumption in Africa. The relation between cancer and food suggests that fumonisin contamination rather than aflatoxin is the most likely factor in maize promoting HIV. Changes to the quality of maize may avoid up to 1,000,000 transmissions of HIV annually. Am J Clin Nutr 2010;92:154–60. INTRODUCTION Large variations in HIV transmission rates are observed between African social groups and nations, and these differences have been the focus of significant research to understand the epidemiology of the disease and to develop interventions against the spread of the disease. Early research established links between social behavior and transmission rates. Many of these factors, such as male circumcision (1), other sexually transmitted diseases (2), faith (3), and partner concurrency (4) have been further studied and proven important (5) through detailed study, models, or clinical trials. Food and nutritional factors have not received that same attention from a transmission perspective, but micronutrients in particular have been studied for their role in the progression of HIV (6). Mycotoxin contaminants in foods may also be important in the HIV epidemic, for instance, chronic aflatoxicosis is associated with immune suppression (7) and a reduction in essential nutrients and may result in deficiencies known to promote HIV progression (8). HIV infection combined with high concentrations of the aflatoxin-albumin adduct biomarker have been associated with a decreased potential for antibody responses, decreased immune cytotoxic activity, and decreased numbers of regulatory T cells, which may result in hyperactivation of the immune system (9). Thus, dietary sources of aflatoxin are a potential factor in the HIV epidemic.
Description: This Article was published by The American Journal of Clinical Nutrition 2010 Jul;92(1):154-60. doi: 10.3945/ajcn.2009.28761. Epub 2010 May 19.
URI: http://hdl.handle.net/123456789/9676
Appears in Collections:College of Science

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