Detection and Concentration of Plasma Aflatoxin is Associated with Detection of Oncogenic Human Papillomavirus in Kenyan Women

Jianjun Zhang; Omenge Orang'o; Philip Tonui; Yan Tong; Titus Maina; Stephen Kiptoo; Katpen Muthoka; John Groopman; Joshua Smith; Erin Madeen; Aaron Ermel; Patrick Loehrer; Darron R Brown

doi:10.1093/ofid/ofz354

Detection and Concentration of Plasma Aflatoxin is Associated with Detection of Oncogenic Human Papillomavirus in Kenyan Women

Open Forum Infect Dis. 2019 Sep 2;6(9):ofz354. doi: 10.1093/ofid/ofz354.

Authors

Jianjun Zhang¹, Omenge Orang'o², Philip Tonui², Yan Tong³, Titus Maina⁴, Stephen Kiptoo⁵, Katpen Muthoka⁵, John Groopman⁶, Joshua Smith⁶, Erin Madeen⁶, Aaron Ermel⁷, Patrick Loehrer⁷, Darron R Brown^{7

8}

Affiliations

¹ Department of Epidemiology, Fairbanks School of Public Health, Indiana University, Indianapolis, IN, USA.
² Department of Reproductive Health, Moi University, Eldoret, Kenya.
³ Department of Biostatistics, Indiana University School of Medicine and Fairbanks School of Public Health, Indianapolis, IN, USA.
⁴ Department of Molecular Biology, Maseno University, Kenya.
⁵ Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.
⁶ Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA.
⁷ Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
⁸ Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, IN, USA.

Abstract

Background: Cervical cancer is common in Kenyan women. Cofactors in addition to infection with oncogenic human papillomavirus (HPV) are likely to be important in causing cervical cancer, as only a small percentage of HPV-infected women will develop this malignancy. Kenyan women are exposed to dietary aflatoxin, a potent carcinogen and immunosuppressive agent, which may be such a co-factor.

Methods: Demographics, behavioral data, plasma, and cervical swabs were collected from 88 HIV-uninfected Kenyan women without cervical dysplasia. HPV detection was compared between women with or without plasma AFB1-lys and evaluated in relation to AFB1-lys concentration.

Results: Valid HPV testing results were available for 86 women (mean age 34.0 years); 49 women (57.0%) had AFB1-lys detected and 37 (43.0%) had none. AFB1-lys detection was not associated with age, being married, having more than secondary school education, home ownership, living at a walking distance to health care ≥60 minutes, number of lifetime sex partners, or age of first sex. AFB1-lys detection and plasma concentrations were associated with detection of oncogenic HPV types.

Conclusions: AFB1-lys-positivity and higher plasma AFB1-lys concentrations were associated with higher risk of oncogenic HPV detection in cervical samples from Kenya women. Further studies are needed to determine if aflatoxin interacts with HPV in a synergistic manner to increase the risk of cervical cancer.

Grants and funding

U54 CA190151/CA/NCI NIH HHS/United States