[2] In contrast, no contemporaneous decline in cell-associated virus was observed. The sustained viral burden in PBMC might be relevant in dengue pathogenesis since DENV-infected cells serve both as producers of pro-inflammatory cytokines, including TNFα and IL-6 [20] and also as antigen-presenting cells capable of inducing cytokine production by DENV-specific T cells. Here, TNF is linked to dengue disease.