Hepatitis C virus (HCV) antibodies detected by radioimmunoassay (RIA) and immunoblot assay were determined in 139 patients with alcoholic liver disease (ALD). Risk factors for exposure to HCV were recorded. Anti-HCV was detected by RIA in 38 (27%), but only 18 (13%) were confirmed with an immunoblot assay. One hundred seven (77%) had risk factors. Of these 107, anti-HCV was detected in 36 by RIA and in 17 by immunoblot assay. Only 2 of 32 patients without risk factors had anti-HCV detected by RIA (1 was reactive with immunoblot, p < 0.05 vs. patients with risk factors). Parenteral drug use and multiple heterosexual contacts were significantly associated with anti-HCV. Age, sex, duration of alcoholism, race, and birthplace did not correlate with detectable HCV antibodies.