508 Japanese patients with chronic liver disease, including chronic hepatitis, cirrhosis and hepatocellular carcinoma, and 500 controls matched for sex and age were studied. Antibody to hepatitis C virus (anti-HCV) alone was found in 233 (45.9%) patients and hepatitis B surface antigen (HBsAg) alone was present in 128 (25.2%) patients. Both anti-HCV and HBsAg were present in 18 (3.5%) patients. Anti-HCV was found in 8 (1.6%) controls and HBsAg was present in 4 (0.8%) controls. The prevalence of anti-HCV alone was 36.9% in chronic hepatitis, 49.0% in cirrhosis and 67.0% in hepatocellular carcinoma, respectively. The prevalence of anti-HCV increased with the progress of severity of liver disease. Anti-HCV was more prevalent than HBsAg both in cirrhosis and hepatocellular carcinoma (p less than 0.001). The prevalence of anti-HCV increased with age. Among patients under age 39 years, HBsAg was detected more often than anti-HCV, however, in those over age 50 years, anti-HCV was detected more often than HBsAg (p less than 0.001). It would appear that hepatitis C virus more than hepatitis B virus is a prominent cause of chronic liver disease among Japanese patients.