Famous composer Ludwig van Beethoven had a probable genetic predisposition to liver disease and hepatitis B infection months before his death, research has shown.
A team of researchers from the University of Cambridge analyzed five strands of hair to sequence the composer's genome.
However, they could not determine the definitive cause of his hearing loss.
Tristan Beg, lead author of the study, said genetic risk factors, along with Beethoven's heavy alcohol consumption, may have contributed to his liver condition.
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An international team analyzed hair from eight strands of hair held in public and private collections to try to shed light on Beethoven's health problems.
The researchers said the five strands were "authentic" and came from a single European man.
Ludwig van Beethoven was born in 1770 in Bonn, Germany and died at the age of 56 in Vienna in 1827.
The prodigious composer and pianist suffered progressive hearing loss, which began in his mid-to-late twenties and resulted in him becoming functionally deaf by 1818.
Begg said that a team of scientists assumed from the composer's "conversation books" - which he used in the last decade of his life - that Beethoven regularly consumed alcohol, but that it was difficult to assess the quantities involved.
"While most of Beethoven's contemporaries claim his consumption was moderate by early 19th-century Viennese standards, it probably amounted to amounts of alcohol now known to be harmful to the liver," he said.
"If his alcohol consumption was high enough over a long period of time, an interaction with his genetic risk factors is one possible explanation for cirrhosis."
The team said, based on genomic data, Beethoven's digestive problems were not caused by celiac disease or lactose intolerance.
"We cannot say for sure what killed Beethoven, but we can now at least confirm the presence of a significant hereditary risk and hepatitis B virus infection.
"We can also eliminate several other less plausible genetic causes," said Johannes Krause, of the Max Planck Institute for Evolutionary Anthropology in Germany.
Axel Schmidt, from the Institute of Human Genetics at the University Hospital of Bonn, said:
"Although no clear genetic basis for Beethoven's hearing loss can be identified, scientists caution that such a scenario cannot be ruled out."
Genealogists have also identified what they describe as an "extra-pair paternity event"—a child resulting from an affair—in Beethoven's direct paternal line.
"We hope that by making Beethoven's genome publicly available to researchers, and perhaps adding additional authentic strands to the initial chronological series, the remaining questions about his health and genealogy will one day be answered," Begg added.
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