Are Aflatoxins a Cause of Parenchymal Liver Disease in Humans?

In 2014 a hepatitis research team noticed that an unusually high amount of people in eastern Ethiopia had chronic liver disease (CLD) and cirrhosis. Aflatoxins, a group of mycotoxins produced by Aspergillus fungi, were suspected as the culprit. Aflatoxins attack certain agricultural products grown or stored under certain conditions and are known hepatocarcinogens. This literature review looks at the evidence for and against aflatoxins as a cause of parenchymal liver disease in humans. In January 2015 the most common medical databases were searched using search terms including aflatoxin, liver disease and cirrhosis, with 68 articles identified as relevant. Further reading led to 17 articles being selected, with two of these identified via the reference lists of the other articles. Three articles were about previous incidents of acute liver failure, where aflatoxins were proven to be the culprit. Seven looked into CLD in humans, where about half of the articles supported that aflatoxins could cause CLD, while a few showed some evidence against it. The last seven articles were various animal studies, mostly using birds, where a few showed cirrhotic changes and several showed various histopathological parenchymal liver changes, though different animals seemed to react differently to aflatoxin exposure. From the articles identified in this literature review, aflatoxins have been shown to cause acute parenchymal liver disease in humans and may cause chronic parenchymal liver disease in humans. However, little research has been done in this field, and further studies are required to draw a conclusion