{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T09:30:38Z","timestamp":1786527038262,"version":"build-2736575974"},"reference-count":44,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004493","name":"IAEA","doi-asserted-by":"crossref","award":["D52044"],"award-info":[{"award-number":["D52044"]}],"id":[{"id":"10.13039\/501100004493","id-type":"DOI","asserted-by":"crossref"}]},{"name":"European Union Horizon 2020 program","award":["825510"],"award-info":[{"award-number":["825510"]}]},{"award":["825510"],"award-info":[{"award-number":["825510"]}],"id":[{"id":"https:\/\/ror.org\/019w4f821","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Fungi","JoF"],"abstract":"<jats:p>Aflatoxin B1\u00a0(AFB1), a dietary mycotoxin classified as a Group 1 carcinogen and a risk factor for hepatocellular carcinoma (HCC), has seen limited biomarker-based evidence linking it to HCC in South America despite favorable regional contamination conditions. Utilizing a newly validated isotope-dilution HPLC\u2013MS\/MS method to quantify AFB1-Lysine (AFB1-Lys) adducts, we conducted a cross-sectional study involving 92 HCC patients and 70 healthy controls across six South American nations. The primary case\u2013control analysis, focusing on 64 HCC patients and 70 controls from Argentina and Colombia, revealed that AFB1-Lys concentrations and positivity rates were significantly higher in HCC cases compared to controls (7.16 vs. 0.89 pg\/mg albumin; 43% vs. 10%). Multivariable logistic regression demonstrated that detectable AFB1-Lys was significantly and independently associated with HCC (adjusted OR = 3.72), with associations most pronounced, though based on small subgroups, in viral hepatitis-related and cryptogenic HCC. Furthermore, broader regional analysis indicated higher AFB1-Lys positivity rates in HBV-positive patients than in HCV-positive or non-viral HCC cases. Ultimately, chronic dietary aflatoxin exposure shows a consistent, statistically significant association with hepatocarcinogenesis across diverse etiological backgrounds in South America, highlighting an urgent need for integrated regional food safety surveillance and expanded prospective studies.<\/jats:p>","DOI":"10.3390\/jof12080560","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T08:20:18Z","timestamp":1785486018000},"page":"560","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Aflatoxin B1 Exposure and Hepatocellular Carcinoma in South America: A Multinational Cross-Sectional Analysis"],"prefix":"10.3390","volume":"12","author":[{"given":"Ram\u00f3n","family":"Asis","sequence":"first","affiliation":[{"name":"Departamento de Bioqu\u00edmica Cl\u00ednica-Centro de Investigaci\u00f3n en Bioqu\u00edmica Cl\u00ednica e Inmunolog\u00eda (CIBICI), Facultad de Ciencias Qu\u00edmicas, Universidad Nacional de C\u00f3rdoba-Consejo Nacional de Investigaciones Cient\u00edficas y T\u00e9cnicas (CONICET), C\u00f3rdoba 5000, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina L.","family":"Fernandez","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n en Medicina Traslacional \u201cSevero R. Amuch\u00e1stegui\u201d (CIMETSA-CONICET), Instituto Universitario de Ciencias Biom\u00e9dicas de C\u00f3rdoba (IUCBC), C\u00f3rdoba 5000, Argentina"},{"name":"Hospital Privado Centro Medico de C\u00f3rdoba S.A. (HPCMC), C\u00f3rdoba 5000, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gustavo","family":"Bonacci","sequence":"additional","affiliation":[{"name":"Departamento de Bioqu\u00edmica Cl\u00ednica-Centro de Investigaci\u00f3n en Bioqu\u00edmica Cl\u00ednica e Inmunolog\u00eda (CIBICI), Facultad de Ciencias Qu\u00edmicas, Universidad Nacional de C\u00f3rdoba-Consejo Nacional de Investigaciones Cient\u00edficas y T\u00e9cnicas (CONICET), C\u00f3rdoba 5000, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose","family":"Debes","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Minnesota, Minneapolis, MN 55455, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jhon","family":"Prieto","sequence":"additional","affiliation":[{"name":"Centro de Enfermedades Hep\u00e1ticas y Digestivas (CEHYD), Bogot\u00e1 110111, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8607-1616","authenticated-orcid":false,"given":"Andre","family":"Boonstra","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9598-2577","authenticated-orcid":false,"given":"Domingo C.","family":"Balderramo","sequence":"additional","affiliation":[{"name":"Hospital Privado Centro Medico de C\u00f3rdoba S.A. (HPCMC), C\u00f3rdoba 5000, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6328-9070","authenticated-orcid":false,"given":"Pablo A.","family":"Romagnoli","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n en Medicina Traslacional \u201cSevero R. Amuch\u00e1stegui\u201d (CIMETSA-CONICET), Instituto Universitario de Ciencias Biom\u00e9dicas de C\u00f3rdoba (IUCBC), C\u00f3rdoba 5000, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"key":"ref_1","unstructured":"IARC (2026, March 03). 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