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The purpose of this study was to screen for the presence of hepatitis B surface antigen and aflatoxins in the sera of 100 non-hospitalized individuals from the rural population of Igbo-Ora and 89 non-hospitalized individuals from the urban population of Ibadan, Nigeria. Hitherto, such a study as this has not been undertaken in this environment. The proportions of hepatitis B surface antigen carriage and serum 'pathologic' levels of aflatoxins were high (47-49%, 8.2-9.0% respectively) but varied very little between the two different populations sampled. These findings indicate that determined efforts should be instituted to reduce or eliminate hepatitis B virus infection and aflatoxin contamination of high risk foodstuffs from this environment.

Nigeria is a very high risk area for primary hepatocellular carcinoma and this is the first study to utilize measurements of both hepatitis B virus status and aflatoxin levels in the same patients to determine the role of these factors in the causation of liver cancer in this environment. We have shown that there is a higher prevalence of hepatitis B surface antigen (P < 0.005) and higher 'pathologic' serum levels of aflatoxins (P < 0.05) in patients with primary hepatocellular carcinoma than in matched controls. It is considered that the results of this study may strengthen the hypothesis that hepatitis B virus may be an important aetiological factor in the development of primary hepatocellular carcinoma. Further work is in progress to correlate the level of aflatoxin serum albumin adducts with liver damage in order to assess the value of the albumin adduct as a marker of risk of liver cancer development.