Aflatoxins are mutagenic hepatocarcinogenic fungal metabolites that contribute to chronic hepatitis B and C and viral cirrhosis, which can both evolve into hepatocellular carcinoma. Objective: To identify and quantify free aflatoxins and AFB 1 -N 7 -guanine (AFB 1 -N 7 -Gua) adducts (active carcinogen) in the urine of Mexican patients with chronic liver diseases. Methods: Urine samples from 210 Mexican patients with chronic liver diseases, hepatitis B or C, or viral cirrhosis and four control

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... oups: 1) patients with alcoholic cirrhosis, 2) patients with no hepatic diseases, 3) patients with kidney failure, and 4) healthy persons, were analyzed for free aflatoxins and AFB 1 -N 7 -Gua adducts by Inhibitory Indirect ELISA and high performance liquid chromatography, and both methods produced similar results (R 2 =0.90). A questionnaire regarding foods with high risk of containing aflatoxins was applied to relate diet and disease. Results: Aflatoxin-positive samples were found from patients in the following groups: hepatitis B (50%), viral cirrhosis (26%), hepatitis C (16.6%), alcoholic cirrhosis (10%), healthy (10%), kidney failure (0.47%), and chronic nonhepatic diseases (0%), with R 2 =0.95. Risk groups had more AFB 1 -N 7 -Gua adducts than controls. High performance liquid chromatography identified free AFB 1 (exposure), types M 1 and P 1 (detoxification metabolites), and Inhibitory Indirect ELISA quantified AFB 1 -N 7 -Gua adduct (a DNA repair biomarker). High-risk foods related (P≤0.001) to hepatic diseases were maize, oil seeds, and dairy products. Conclusion: Mexican patients with chronic liver diseases exhibited high concentrations of aflatoxins and Aflatoxin-N 7 -Gua adducts, both of which showed high exposure and the last are significant biomarkers for the risk of liver diseases that predispose patients to liver cancer.