Relation between aflatoxin, hepatitis-B virus, and hepatocellular carcinoma.

A new role is postulated for aflatoxin in the production of hepatocellular carcinoma. Rather than acting as a primary carcinogen, as it seems to do in animals, it is suggested that aflatoxin suppresses cell-mediated immunity. This effect on the immune system would allow the hepatitis-B virus, highly endemic in certain populations, to maintain itself more easily in the liver, to produce more chronic infection and cirrhosis, and in the long term to lead to a high incidence of hepatocellular carcinoma.