AKT-2461

A 57-year-old male presents with generalised fatigue and upper abdominal discomfort with some weight loss over the last six months.

He has otherwise been well but admits to consuming 10 units of alcohol per day.

On examination you note 2 cm hepatomegaly.

Liver function tests show an:
ALT 100 IU/L (5-35)
AST 210 IU/L (1-31)
Alkaline Phosphatase 250 IU/L (45-105)
MCV 110 fL (80-96)

Which of the following is the most likely cause of his presentation?