Objective. To examine the relationship of rheumatoid factor (RF) to HLA-DR4 and alleles of DRBl in women with recent-onset rheumatoid arthritis (RA).Methods. Incident cases of RA were identified as part of a prospective, population-based cas-ontrol study. HLA typing was completed for 246 cases meeting criteria for definite or classic RA.Results. One hundred thirty-six patients (55%) were positive for DR4, and 130 (53%) were RF positive. DR4 was found to be strongly associated with seropositivity (odds ratio 4.1, P < 0.0001). Patients with a shorter interval from RA onset to RF testing had a higher frequency of seropositivity than those with a longer interval (518 months 60%, >18 months 33%). Further analysis of patients who had RF testing within 18 months of RA onset showed that the frequency of seropositivity was significantly greater among DR4-positive patients who had the shared sequence stretch of DRPl associated with RA susceptibility (76% RF positive) than among DR1-positive patients who had this sequence (45% RF positive) (odds ratio 3.8, P = 0.01).Moreover, the frequency of seropositivity among DR1-