Three out of 16 patients with chronic active hepatitis (CAH) had total or subtotal villous atrophy in a suction biopsy taken from the upper jejunum. One of the three patients had a history of intestinal dysfunction. The patients with abnormal intestinal mucosa had lower levels of serum albumin and higher levels of IgG than patients without intestinal mucosal changes. The occurrence of intestinal villous atrophy in CAH may be due to a genetically determined disposition to CAH and coeliac disease associated with HLA-B8, which was carried by all three patients. The present findings have led to trials with gluten-free diet in CAH associated with intestinal villous atrophy.