Hi there, It s usually not just one factor, but anything that damages the liver can contribute to cirrhosis. Hepatitis A may have had an affect and damaged some of his liver. Alcohol also has a profound effect on causing liver damage. The problem is that when the liver gets damaged, it doesn t heal exactly the same way it was before, becomes scarred, and you get what is called cirrhosis. He may have early cirrhosis given his age. At this point, it really doesn t matter what caused it. The fact is that he has some degree of cirrhosis, which means he has some degree of irreversible liver damage. The goal now is to prevent any more damage to his liver. That means no more drinking at all. If I had any hint of cirrhosis, I would stay far, far away from alcohol (maybe a glass of champagne at your future wedding would be ok). I d also recommend he avoid fatty foods, as non-alcoholic steatohepatosis or NASH, can cause damage to the liver. This is basically having a fatty liver, which also can lead to cirrhosis. Finally, I d recommend he get an ultrasound of his liver every 6 months, as well as liver enzyme tests, and have his alphafetoprotein levels checked (marker for liver cancer), as he is at increased risk of liver cancer due to his history of cirrhosis. Just remember - just because he has cirrhosis doesn t mean he can t live a healthy life without further problems. He just has to take good care of the liver he has left! I hope I have answered your question. Please feel free to contact me if you have any further questions.