Introduction

The combined pathogenesis of Aflatoxin B1 (AFB1) and several viruses such as HBV, EBV and influenza virus have been investigated yet the molecular mechanism of their interaction and possible synergistic effects is not fully understood.

Objectives

The aim of the current systematic review was to review in-vitro and in-vivo studies investigating the combined pathogenesis of aflatoxins and viruses.

Methods

This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. PECO (Population, Exposure, Comparator, and Outcome) criteria for invitro and invivo studies were used to evaluate the eligibility of the studies for systematic review.

Results

21 studies were eligible for qualitative analysis based on the inclusion criteria. Of all the included studies, 9 (42.9 %) were invivo, 7 (33.3 %) were invitro-invivo and 5(23.8) articles conducted only invitro assay. Furthermore 14 (66.6 %) article explored hepatitis B virus (HBV) combination with AFB1, 4 (19 %) studied influenza A virus (SIV), 2 (9.7 %) were about Epstein–Barr virus (EBV) and only 1 (4.7 %) included hepatitis C virus (HCV).

Conclusion

The limited collected evidence suggests that AFB1 enhanced EBV and influenza virus pathogenesis. AFB1 also operated as a cofactor for HBV and EBV-mediated carcinogenesis. On the other hand HBV and HCV also induced AFB-1 carcinogenesis. Due to the limited amount of included studies and the inconsistency of their results further studies especially on HBV and SIV are essential for better understanding of their combined mechanisms.

中文翻译：

---

黄曲霉毒素 B1 和病毒的联合发病机制：体外和体内研究的小型系统学回顾

 介绍

黄曲霉毒素 B1 (AFB1) 与 HBV、EBV 和流感病毒等多种病毒的联合发病机制已被研究，但它们相互作用的分子机制和可能的协同作用尚不完全清楚。

 目标

当前系统评价的目的是评价调查黄曲霉毒素和病毒联合发病机制的体外和体内研究。

 方法

本系统评价是根据系统评价和荟萃分析的首选报告项目 (PRISMA) 指南进行的。体外和体内研究的 PECO（群体、暴露、比较和结果）标准用于评估系统评价研究的资格。

 结果

根据纳入标准，21 项研究符合定性分析条件。在所有纳入的研究中，9 篇（42.9%）为体内研究，7 篇（33.3%）为体外-体内研究，5 篇（23.8）篇文章仅进行体外测定。此外，14 篇 (66.6 %) 篇文章探讨了乙型肝炎病毒 (HBV) 与 AFB1 的组合，4 篇 (19 %) 篇文章研究了甲型流感病毒 (SIV)，2 篇 (9.7 %) 篇文章研究了 Epstein-Barr 病毒 (EBV)，只有 1 篇 (4.7 %) 包括丙型肝炎病毒 (HCV)。

 结论

收集到的有限证据表明 AFB1 增强了 EBV 和流感病毒的发病机制。 AFB1 还作为 HBV 和 EBV 介导的致癌作用的辅助因子。另一方面，HBV和HCV也诱导AFB-1致癌。由于纳入的研究数量有限且结果不一致，进一步的研究，尤其是针对 HBV 和 SIV 的研究，对于更好地了解其联合机制至关重要。