TNF and visceral leishmaniasis: However, in addition to a single study that suggested a role for LDL in the development of VL through tumor necrosis factor-α (TNF-α) production [22], our study is the first to clearly find that the LPL genotype that leads to a phenotype of high VLDL-C levels, high TAG levels, and low HDL-C levels is a risk factor for active visceral leishmaniasis.