The potential for an individual to be infected with dengue virus on several different occasions during a lifetime, as described above, is a distinctive clinical and immunological feature of dengue.
secondary dengue virus infections differ immunologically from primary infections as a consequence of the fact that the immune response (to the secondary infection) occurs in the context of pre-existing heterotypic immunity that is serotype cross-reactive.
. However, because of sequence diversity between the dengue virus serotypes, the memory B and T cells that are re-activated during secondary infection may not have optimal avidity for the corresponding epitopes of the new infecting virus.
homotypic versus heterotypic neutralizing antibody titre
Titres of antibodies specific for the virus serotype that caused the earlier infection increase substantially, and often remain higher than the titres of antibodies specific for the currently infecting serotype57,59, the phenomenon that led to the original coinage of the term original antigenic sin
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