Liu et al. prospectively followed 6,403 children who had the HLA haplotype DR3–DQ2 or DR4–DQ8 from birth. HLA haplotype DR3–DQ2 conferred a high risk of developing coeliac disease autoimmunity and coeliac disease in early childhood, particularly in those children who were homozygous. The risk of coeliac disease was highest in Sweden (compared with Finland, Germany and the USA), which the authors say highlights the importance of also studying environmental factors.