ALB and Hepatic failure: Three studies scored a probably low RoB, based upon the ideal aflatoxin measurement (i.e. AFB1 albumin or AFB1 lysine adduct in plasma or serum), and the consideration of other influencing factors such as exposure to other toxins, co-existence of virology factors (e.g. acute liver failure induced by hepatitis B), as well as liver failure due to medication and/or alcohol use.