Peer-reviewed article
Assessing the relationship between chronic aflatoxin exposure and hepatitis B virus immune protection in a population of children receiving nutritional support in Rwanda
MA Matabishi, E. De Rycke, A. Chen, S. De Saeger, F. Mutua et al. ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This study looked at whether long-term exposure to aflatoxins (toxins from mould on food) was linked to protection from hepatitis B vaccination in Rwandan children receiving nutritional support. It included 216 children aged 7 to 59 months: 70 with malnutrition and 146 controls. Aflatoxin exposure was not independently linked to hepatitis B antibody levels. Nutritional status was linked to antibody levels, with the control group having higher levels than the malnutrition group. The authors suggest that nutritional support may help immune protection in children.
Key points
- 216 children aged 7–59 months were enrolled: 70 malnutrition cases and 146 controls.
- Anti-HBs levels varied widely (median 84.8 IU/ml, IQR 14.0–283.4).
- AFB1-lysine was found at a mean of 23.43 ± 5.76 pg/mg albumin; AFB1, AFB2, AFG1 and AFG2 were not detected above the limit of detection.
- Aflatoxin exposure showed no independent association with Anti-HBs levels (β = −0.003, 95% CI −0.031–0.025, p = 0.832).
- After adjustment, controls had higher Anti-HBs levels than cases (β = 0.573, 95% CI 0.076–1.070, p = 0.024).
Limitations
The abstract describes an association analysis of one group of children at one point in time, so it cannot show cause and effect. The findings come from children receiving nutritional support in Rwanda and may not apply to other children or settings.
Abstract
Chronic aflatoxins exposure may impair immune function, but evidence in African children is limited. We assessed their association with hepatitis B surface antibody (Anti-HBs) levels in Rwandan children receiving nutritional support for malnutrition recovery or prevention. A total of 216 children aged 7–59 months were enrolled, including 70 malnutrition cases and 146 controls. Anti-HBs concentrations were measured using the ARCHITECT System (Abbott Diagnostics), and aflatoxins (AFB1, AFB2, AFG1, AFG2 and AFB1-lysine) were quantified by liquid chromatography-tandem mass spectrometry (LC–MS/MS). Anti-HBs levels were highly variable (median = 84.8 IU/ml, IQR 14.0–283.4). Serum analysis for AFB1-lysine revealed a mean concentration of 23.43 ± 5.76 pg/mg albumin, while none of the samples showed detectable levels of AFB1, AFB2, AFG1, or AFG2 above the limit of detection. In unadjusted analyses, no significant differences in Anti-HBs or aflatoxin levels were observed between cases and controls (Mann–Whitney U, p = 0.452 and p = 0.119, respectively) or between sexs (t-test, p = 0.642 and p = 0.352). Age was not correlated with aflatoxin levels (r = 0.06, p = 0.556). In multivariable linear regression analyses adjusting for age, place of residence, socioeconomic status, and sex, nutritional status emerged as a significant determinant of Anti-HBs levels. Specifically, the control group had higher Anti-HBs levels than the case group (β = 0.573, 95% CI 0.076–1.070, p = 0.024), while aflatoxin exposure showed no independent association with Anti-HBs levels (β = − 0.003, 95% CI − 0.031–0.025, p = 0.832). These findings suggest that, in this population, nutritional status rather than chronic aflatoxins burden, is the primary determinant of Anti-HBs response, highlighting the importance of targeted nutritional interventions to support immune protection in children.