Mutant p53 protein is prevalent in Aflatoxin B1 than in Hepatitis B Core antigen associated chronic liver diseases in Southern Nigeria

Background: Aflatoxin B1 (AFB1), hepatitis B virus (HBV) and p53 mutation are major risk factors for liver cancer. However, the presence of AFB1 and expression of mutant p53 protein during active HBV replication (nuclear expression of Hepatitis B Core Antigen; HBcAg) and HBV clearance (nuclear expression of HBcAg) is still under-investigated in Africa. Objectives: This study assessed the prevalence, extent of expression, interaction, and risk associated with single and binary expression of AFB1, HBcAg and mutant p53 (mtp53) in liver diseases in relation to age and sex. Materials and Methods: This retrospective study included 14 and 74 cases of liver cancer (LC) and chronic hepatitis, respectively. Tissues were histochemically and immunohistochemically stained, scored and documented as positive (+) or negative (-) for antigen. Result: In this study, the prevalence of AFB1, HBcAg, and mtp53 were 76.1%, 40.9%, and 61.4%, respectively. Higher prevalence and expression of AFB1 was observed in chronic hepatitis than in LC (p= 0.035 and 0.028, respectively). Higher prevalence of AFB1 and mtp53 and lower prevalence of HBcAg were observed in females than in males (p= 0.186, 0.0003 and 0.062, respectively). Cytoplasmic expression of HBcAg was higher in males (58 than in females were 58.6% (17/29) and 14.3% (1/7), respectively (p= 0.088). AFB1+ and HBcAg+ females were more and less likely to develop LC than males (OR: 3.00 and 0.39, 95%CI: 0.10-4.18 and 0.44-12.20, p= 0.012 and 0.003), respectively. AFB1+mtp53- (23.9%), AFB1+mtp53+ (52.3%), HBcAg+mtp53- (13.6%), HBcAg+mtp53+ (27.3%) and AFB1+HBcAg+ (34.1%) increased liver cancer risk (OR: 6.45, 21.50, 2.80, 0.78, and 5.11; 95%CI: 0.89-29.29, 0.95-43.86, 2.96-156.13, 0.60-13.01, and 0.14-4.25; p= 0.057, 0.002, 0.189, 0.772, and 0.067, respectively). Conclusion: This study suggests that women are at a higher risk of AFB1 exposure and p53 mutation, but are at a lower risk of viral replication than men.