Autoimmune HEPATITIS (AIH) is one of causes of chronic liver diseases. It is an unresolving inflammation of liver tissue and characterized by elevated transaminases, hypergammaglobulinemia, and circulating autoantibodies. The disorder occurs mostly in females (F:M ratio is 3.6 to 1) and is a relatively uncommon disorder with point prevalence of 8-16.8 per 100 000 population in western countries. Hiostologic hallmarks are interface HEPATITIS (also called piecemeal necrosis), and portallymphoplasmacytic infiltration.Dignostic criteria are based on excluding other etiologies of chronic liver disease,such as viral hepatic (A, B, C), metabolic disorders eg Wilson disese,drug induced HEPATITIS and alcoholic liver disease. Conventional autoantibodies are Antinuclear antibody (ANA), Smooth muscle antibody (SMA) and Anti liver kidney microsomal 1 (Anti LKM1).Some cases have combined clinical, laboratory or histologic features of Primary Biliary Cirrhosis (PBC) or Primary Sclerosing Cholangitis (PSC) with AIH and are known as overlap syndrome. Standard treatments of AIH as the most successful treated form of chronic HEPATITIS are based on immunosuppression with corticosteroids alone or in combination with azathioprine.

Background: Aflatoxins are the secondary metabolites produced by the flavi section of Aspergillus. Aflatoxin B1 (AFB1) is hepatocarcinogen, teratogen and mutagen. Aflatoxin M1 (AFM1) is the hydroxylated metabolite of AFB1. The liver protects the body by lowering the toxicity of AFB1 to form different hydroxylates like AFM1. According to the synergistic effect of HEPATITIS and also AFB1 as the parent molecule of AFM1, the main purpose of this study was to assess the relationship between the mean levels of AFM1, in the HEPATITIS-C-virus (HCV) -positive patients compared to healthy individuals.Methods: After the tests of liver function enzymes, the level of AFM1 was measured and compared in the urine sample of 71 patients with HCV and 71 healthy individuals. The AFM1 of urine samples were tested using enzyme-linked immunosorbent assay (ELISA) method. Besides, the levels of serum glutamic-oxaloacetic transaminase (SGOT), serum glutamic-pyruvic transaminase (SGPT), alkaline phosphatase, total bilirubin and direct bilirubin were assessed in the blood samples.Findings: The urine of 29.7% of HCV-positive patients and 19.71% of healthy individuals consisted of some amount of AFM1. The mean level of AFM1 was 2.45 and 1.66 pg/ml in patients and controls, respectively; which was significantly different (P=0.005). The mean levels of SGPT and alkaline phosphatase were significantly more among HCV-positive patients with AFM1 compared to those without AFM1 (P=0.012). But, there was not any significant difference between the mean levels of SGOT and total and direct bilirubin between the HCV-positive patients with and without AFM1.Conclusion: The mean levels of SGPT and Alkaline phosphatase, which are more exclusive to survey of liver function, were significantly different between HCV-positive patients with and without AFM1. Consequently, progression of the chronic liver disease is caused by the existence of AFB1 in HCV-positive patients; therefore, the reduction of AFM1 via improving the food consumption pattern can prevent this progression.