The clinical and histologic changes in 116 Japanese patients with persistent HBs-antigenemia and chronic liver diseases were analyzed after the patients were divided into three groups depending on the history of alcohol consumption. Group 1 consisted of 45 nondrinkers, Group 2 of 51 social drinkers, and Group 3 of 20 habitual drinkers with a daily intake of more than 60 g of ethanol for at least ten years. The frequency of chronic active hepatitis (CAH) in Group 3 was higher than in Groups 1 and 2 (P less than 0.05). The histologic comparison of patients with CAH between the three groups revealed that only the inflammatory changes at/near portal tracts, such as piecemeal necrosis and inflammatory cell infiltration in Group 3, were more prominent than those in Groups 1 and 2. The alcohol-related changes except for fatty change were not found in any specimens. These findings suggest that alcohol intake, particularly of more than 60 g of ethanol a day, may enhance the viral inflammatory changes of the liver in patients with persistent HBs-antigenemia.