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

Research output: Contribution to journalArticlepeer-review


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, because 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 cofactor. Methods: Demographics, behavioral data, plasma, and cervical swabs were collected from 88 human immunodeficiency virus-uninfected Kenyan women without cervical dysplasia. Human papillomavirus detection was compared between women with or without plasma aflatoxin B1-lysine (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. The AFB1-lys detection was not associated with age, being married, having more than secondary school education, home ownership, living at a walking distance to healthcare ≥60 minutes, number of lifetime sex partners, or age of first sex. The AFB1-lys detection and plasma concentrations were associated with detection of oncogenic HPV types. Conclusions: The 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 whether aflatoxin interacts with HPV in a synergistic manner to increase the risk of cervical cancer.

Original languageEnglish (US)
Article numberofz354
JournalOpen Forum Infectious Diseases
Issue number9
StatePublished - Oct 5 2019


  • Kenyan women
  • aflatoxin
  • oncogenic human papillomavirus

ASJC Scopus subject areas

  • Oncology
  • Clinical Neurology


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