Of 288 patients with alcoholism and various stages of alcoholic hepatitis, 18.4% (53 of 288) reacted serologically for hepatitis C (HCV). An evaluation of the risk factors associated with HCV indicated that parenteral drug use, even in the distant past, increased the risk for infection 10.1-fold (p = 0.0001). Ethnicity was also a significant, independent risk factor. Minorities (i.e., African-Americans or Hispanic-Americans) had a 2.4-fold increase (p = 0.038). Prior blood transfusions, even if multiple, showed only a tendency toward increased infections (p = 0.088) in this population. An interaction between age and contact with parenteral drug users was demonstrated such that the risk of HCV infection was increased by contact with drug users. This was further increased with increasing age (p = 0.006). There was no relationship between HCV reactivity and the severity of the liver disease; however, the liver injury appeared to be accelerated since it occurred at a younger age (p = 0.0001) and was associated with more frequent hospitalizations (p = 0.0005).