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津巴布韦哈拉雷地区感染和未感染 HIV 的孕妇及哺乳期妇女的霉菌毒素暴露生物监测及其决定因素。

Biomonitoring and determinants of mycotoxin exposures from pregnancy until post-lactation in HIV-infected and HIV-uninfected women from Harare, Zimbabwe.

机构信息

Immunology Unit, Department of Laboratory Diagnostic and Investigative Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe.

Department of Pharmacy and Pharmaceutical Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe.

出版信息

Food Addit Contam Part A Chem Anal Control Expo Risk Assess. 2024 Dec;41(12):1625-1647. doi: 10.1080/19440049.2024.2402553. Epub 2024 Sep 16.

DOI:10.1080/19440049.2024.2402553
PMID:39284005
Abstract

The human immunodeficiency virus (HIV) heavily affects women from resource-limited settings who are vulnerable to potentially harmful mycotoxins including aflatoxin B (AFB1), fumonisin B (FB1) and ochratoxin A (OTA). We aimed to conduct biomonitoring and ascertain the determinants of maternal mycotoxin exposure in pregnancy, lactation and post-lactation periods. We conducted a retrospective longitudinal study in HIV-infected and HIV-uninfected women from Harare, Zimbabwe. 175 and 125 random urine samples in pregnancy and 24 months after delivery (post-lactation) respectively were analysed for aflatoxin M (AFM1) and FB1 by ELISA. 6 weeks after delivery (lactation), 226 and 262 breast milk (BM) samples were analysed for AFM1 and OTA respectively by ELISA. The association of demographics and food consumption with mycotoxins was evaluated using multivariable logistic regression. In HIV-infected, urinary AFM1 was detected in 46/94 (Median: 0.05; Range: 0.04-0.46 ng mL) in pregnancy and 47/66 (Median: 0.05; Range: 0.04-1.01 ng mL) post-lactation. Urinary FB1 was detected in 86/94 (Median: 1.39; Range: 0.17-6.02 ng mL) in pregnancy and 56/66 (Median: 0.72; Range: 0.20-3.81 ng mL) post-lactation. BM AFM1 was detected in 28/110 (Median: 7.24; Range: 5.96-29.80 pg mL) and OTA in 11/129 (Median: 0.20; Range: 0.14-0.65 ng mL). In HIV-uninfected, urinary AFM1 was detected in 48/81 (Median: 0.05; Range: 0.04-1.06 ng mL) in pregnancy and 41/59 (Median: 0.05; Range: 0.04-0.52 ng mL) post-lactation. Urinary FB1 was detected in 74/81 (Median: 1.15; Range: 0.17-6.16 ng mL) in pregnancy and 55/59 (Median: 0.96; Range: 0.20-2.82 ng mL) post-lactation. BM AFM1 was detected in 38/116 (Median: 7.70; Range: 6.07-31.75 pg mL) and OTA in 4/133 (Median: 0.24; Range: 0.18-0.83 ng mL). Location, wealth, and peanut butter consumption were determinants of AFB1 exposure. HIV infection, BMI, location, rainy season, unemployment, and age were determinants of FB1 exposure. Women especially those pregnant and/or HIV-infected are at risk of adverse effects of mycotoxins.

摘要

人类免疫缺陷病毒 (HIV) 严重影响资源有限环境中的妇女,使她们容易受到潜在有害的霉菌毒素的影响,包括黄曲霉毒素 B1 (AFB1)、伏马菌素 B1 (FB1) 和赭曲霉毒素 A (OTA)。我们旨在进行生物监测并确定妊娠、哺乳期和哺乳期后期间产妇霉菌毒素暴露的决定因素。我们在津巴布韦哈拉雷的 HIV 感染者和未感染者中进行了一项回顾性纵向研究。分别分析了 175 份和 125 份随机尿液样本在妊娠期间和分娩后 24 个月(哺乳期后)的黄曲霉毒素 M1 (AFM1) 和 FB1,通过 ELISA 进行分析。分娩后 6 周(哺乳期),通过 ELISA 分析了 226 份和 262 份母乳 (BM) 样本中的 AFM1 和 OTA。使用多变量逻辑回归评估了人口统计学和食物消耗与霉菌毒素的关系。在 HIV 感染者中,在妊娠期间检测到 46/94 例(中位数:0.05;范围:0.04-0.46 ng mL)和哺乳期后 47/66 例(中位数:0.05;范围:0.04-1.01 ng mL)的尿液 AFM1。在妊娠期间检测到 86/94 例(中位数:1.39;范围:0.17-6.02 ng mL)和哺乳期后 56/66 例(中位数:0.72;范围:0.20-3.81 ng mL)的尿液 FB1。在 110 例 BM 中检测到 28 例(中位数:7.24;范围:5.96-29.80 pg mL)和 129 例中的 11 例(中位数:0.20;范围:0.14-0.65 ng mL)的 BM AFM1 和 OTA。在 HIV 未感染者中,在妊娠期间检测到 48/81 例(中位数:0.05;范围:0.04-1.06 ng mL)和哺乳期后 41/59 例(中位数:0.05;范围:0.04-0.52 ng mL)的尿液 AFM1。在妊娠期间检测到 74/81 例(中位数:1.15;范围:0.17-6.16 ng mL)和哺乳期后 55/59 例(中位数:0.96;范围:0.20-2.82 ng mL)的尿液 FB1。在 116 例 BM 中检测到 38 例(中位数:7.70;范围:6.07-31.75 pg mL)和 133 例中的 4 例(中位数:0.24;范围:0.18-0.83 ng mL)的 BM AFM1 和 OTA。位置、财富和花生酱消费是 AFB1 暴露的决定因素。HIV 感染、BMI、位置、雨季、失业和年龄是 FB1 暴露的决定因素。妇女,尤其是孕妇和/或 HIV 感染者,存在霉菌毒素不良影响的风险。

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