Dengue pathogenesis: Host factors

Fortunately, severe dengue is an uncommon outcome of both primary and secondary DENV infections. The syndromic nature of severe dengue (see Chapter 8, this volume) is a reminder that no single host or viral factor should be considered a sole mechanistic cause of this outcome. Instead, a constellation of virological and host variables contribute to the expression of the clinical phenotype. These host and virus variables need to be thought of as risk factors that are measurable on a population-wide scale, but are not necessarily risk factors in individual patients. Here we will review some of the host risk factors associated with severe dengue and identify knowledge gaps where future research could be directed.