TNF and Dengue hemorrhagic fever: The reason for the vascular leakage in DHF patients is the massive release of pro-inflammatory cytokines and chemokines upon viral infection, such as interleukin-6 (IL-6), IL-8, IL-1β, vascular endothelial growth factor, and tumor necrosis factor-α (TNF-α), leading to endothelial cell damage [7].