The changing pattern of liver disease in South African Blacks

Consecutive liver biopsies in a large general hospital for Blacks over the period 1959 - 1960 were compared with those in the 2-year period 1975 - 1976. Changes were noted in the histological appearances of micronodular cirrhosis. With the liberalization of the liquor laws and the granting of access to hard liquor to Blacks, fatty change, alcoholic hepatitis, alcoholic hyalin and alcoholic cirrhosis are making their appearance in the micronodular cirrhosis of the South African Blacks, features which were never observed when alcohol consumption was confined to homebrewed beverages containing large quantities of iron derived from the metallic containers in which liquor is brewed. No change in the histological picture or incidence of macronodular cirrhosis and hepatocellular carcinoma was observed.