Genetic and environmental factors in the individual susceptibility to the development of alcoholic liver disease.

Although there is a dose-response relationship between alcohol consumption and liver damage, less than one-third of alcoholics develop alcoholic liver disease (ALD). This individual susceptibility to the development of ALD may be explained by genetic and environmental factors. Of the genetic factors, female sex is clearly a significant risk factor, HLA status is probably important but further studies are needed, abnormalities in alcohol metabolism have not been shown to be of primary pathogenic importance and the plethora of immunological disturbances reported appear to be mere epiphenomena. Of the environmental factors, no consistent evidence attests to the significance of hepatitis B viral infection in the susceptibility to developing ALD.