ABSTRACT—We have compared the clinical, biochemical and immunological features of patients with biopsy‐proven chronic active hepatitis from Iraq and from the United Kingdom. Clear‐cut differences emerge, which can mostly be attributed to the HBV status, as 91% of patients from Iraq were HBsAg‐positive compared to only 6% from the U.K. Most patients from Iraq presented insidiously with established cirrhosis, while those from the U.K. presented more acutely and systemic symptoms were more common. Autoantibodies and associated autoimmune conditions were common in U.K. patients but extremely rare in