The HLA system and Coxsackie B viral myocarditis in adults

: The distribution of HLA antigens A, B and C was studied in 152 normal donors, 53 patients with Coxsackie B virus myocarditis, 35 patients with myocarditis of unknown origin, 16 coronary patients and 14 rheumatic patients with high titres of anti-Coxsackie virus antibodies. Coxsackie virus myocarditis was associated with increased occurrence of HLA antigens A3, B40, Cw2 and A28, the increase being significant (with an adjustment to the number of the tested antigens) for A3 in severe and medium myocarditis, and B40 in patients who had developed myocarditis before age 30. Antigen Cw2 was more common in myocarditis patients with high titres of anti-Coxsackie virus B4 antibodies. The distribution of HLA antigens in coronary patients was similar to that of the controls. Rheumatic patients showed increased incidence of antigen Cw2. It is suggested that carriers of histocompatibility antigen A3 may be predisposed genetically to severe or medium Coxsackie B virus myocarditis.