Chronic alcohol administration increases gut-derived endotoxin in the portal blood, which activates Kupffer cells through nuclear factor B (NF-B) to produce toxic mediators such as proinflammatory cytokines, leading to liver injury. Therefore, a long-term intragastric ethanol feeding protocol was used here to test the hypothesis that NF-B inhibition would prevent early alcohol-induced liver injury. Adenoviral vectors encoding either the transgene for IB superrepressor (AdIB-SR) or the bacterial -galactosidase reporter gene (AdlacZ) were administered intravenously to Wistar rats. Animals were fed a high-fat liquid diet with either ethanol or isocaloric maltose-dextrin (control) for 3 weeks. There was no significant difference in mean urine alcohol concentrations between the groups fed ethanol. IB-SR expression was increased for up to 2 weeks after injection, but was undetectable at 3 weeks. NF-B activation was increased by ethanol and associated with up-regulation of tumor necrosis factor ␣ (TNF-␣). These increases were blunted significantly up to 2 weeks by AdIB-SR. Dietary alcohol significantly increased liver to body weight ratios and serum alanine transaminase (ALT) levels in AdlacZtreated animals, effects that were blunted significantly in AdIB-SR-treated rats. Ethanol caused severe steatosis, inflammation, and focal necrosis in AdlacZ-treated animals. These pathologic changes were significantly decreased by AdIB-SR. The protective effects of IB-SR were significant 2 weeks after injection, but were lost at 3 weeks when IB-SR was no longer expressed. Ethanol increased 4-hydroxynonenal as a maker of oxidative stress in both AdlacZ and AdIB groups. These data support the hypothesis that NF-B inhibition prevents early alcohol-induced liver injury even in the presence of oxidative stress. (HEPATOLOGY 2001; 34:1149-1157.)