Possible reasons for this include host-derived factors that influence the general quality of the immune response such as haemoglobinopathies which alter display of PfEMP1 on the red cell surface [41]; parasite-induced epigenetic modification of immune cell function [42]; PfEMP1-mediated inflammation resulting in dysregulation of T- and B cell function [43] or antibody-dependent cellular cytotoxic function [44]; and RIFIN-mediated binding to LILRB1 expressed on B cells [45]. Here, LILRB1 is linked to hemoglobinopathy.