Excessive alcohol use can cause fatty liver, alcoholic hepatitis, cirrhosis. Alcoholic cirrhosis accounts for about 40% of the deaths due to cirrhosis. History of excessive alcohol use often denied. Severe forms (hepatitis, cirrhosis) associated with ingestion of 160 g/d for 10-20 years; women more susceptible than men and develop advanced liver disease with less alcohol intake. Hepatitis B and C may be cofactors in the development of liver disease. Malnutrition may contribute to development of cirrhosis.