Safety of honey consumed in Enugu State, Nigeria: a public health risk assessment of lead and polycyclic aromatic hydrocarbons

Background: Information about lead (Pb) and polycyclic aromatic hydrocarbons (PAHs) concentrations in honey and their dietary intake is very important in human health risk assessment. Currently, there are paucity of data on the risk assessment and concentrations of lead and PAHs in honey in Nigeria. Objective: This study has determined the potential human health risk of lead and PAHs associated with the consumption of honey in Enugu state, Nigeria. Materials and methods: Lead and US EPA 16 priority PAHs in honey harvested from rural and urban communities in March 2016 were determined using Atomic Absorption Spectrometer and Gas Chromatograph respectively. Carcinogenic and non-carcinogenic risk assessments were carried. Results: The mean concentration of Pb in honey ranged from 0.005 mg/kg ­ 0.08 mg/kg. The mean concentrations of 16 PAHs in honey ranged from 4.71E-03 ­ 2.72 mg/kg. The dietary intake of the PAHs for adults and children ranged from 0.0021 ­ 0.0259 mg/kg/day and 0.0011 ­ 0.0129 mg/kg/day respectively. The levels of BaPeq and their margin of exposure MOE suggest non-significant health risk. The incremental life cancer risk ILCR of Pb were within safe range of <1E-04. Conclusion: Consumption of honey from Enugu State, Nigeria may not pose a significant health risk_

An Individual Participant Data Population Pharmacokinetic Meta-analysis of Drug-Drug Interactions between Lumefantrine and Commonly Used Antiretroviral Treatment.

Treating malaria in HIV-coinfected individuals should consider potential drug-drug interactions. Artemether-lumefantrine is the most widely recommended treatment for uncomplicated malaria globally. Lumefantrine is metabolized by CYP3A4, an enzyme that commonly used antiretrovirals often induce or inhibit. A population pharmacokinetic meta-analysis was conducted using individual participant data from 10 studies with 6,100 lumefantrine concentrations from 793 nonpregnant adult participants (41% HIV-malaria-coinfected, 36% malaria-infected, 20% HIV-infected, and 3% healthy volunteers). Lumefantrine exposure increased 3.4-fold with coadministration of lopinavir-ritonavir-based antiretroviral therapy (ART), while it decreased by 47% with efavirenz-based ART and by 59% in the patients with rifampin-based antituberculosis treatment. Nevirapine- or dolutegravir-based ART and malaria or HIV infection were not associated with significant effects. Monte Carlo simulations showed that those on concomitant efavirenz or rifampin have 49% and 80% probability of day 7 concentrations <200 ng/ml, respectively, a threshold associated with an increased risk of treatment failure. The risk of achieving subtherapeutic concentrations increases with larger body weight. An extended 5-day and 6-day artemether-lumefantrine regimen is predicted to overcome these drug-drug interactions with efavirenz and rifampin, respectively.