As we haveobserved changes in lipid profile have been previously reported in patients with dengue (2-5). Indeed experimentally has been shown that lipids play an importantrole during dengue virus infection (7-11). Therefore a direct relationship between lipids and dengue is wellestablished. However the relationship between development of severe dengue andchanges in circulating lipid content remains unclear. Lipid metabolism isextensively regulated by cytokines during the host response to infection (12). Being TNF-α is a keypro-inflammatory cytokine whose participation has been implicated in many biological functions as lipid metabolism (13). Thepresence of significantly higher levels of pro-inflammatory cytokines  in serum from either DF or DHF patients iswell established (14-19). According to the literature we found elevated levels of TNF-α in patients with dengue compared to controlindividuals. However TNF-α level did notcorrelate with the circulating lipid profile in patients studied with dengue. Unfortunately we only selected sixteen patients withdengue to determine TNF-α levels this reduced number was a greatlimitation so that these results deserve to be corroborated. As well aswe were unable to evaluate othercytokines such as IL-1β and IL-6 also involved in lipid modification (20 21). Other potentialexplanations for decreased lipids such as serum cholesterol have been proposedin patients with dengue include accumulation in organs as liver cause ofsteatosis is observed (22) the increasedendothelial permeability associated with the severe dengue disease that couldpotentially enable leakage of cholesterol molecules (5) or uptake byDENV-infected cells as cholesterol role implicated in thedengue replicative cycle (8-10). More research isneeded to determine the mechanisms behind these changes in the lipid profile ofpatients infected with dengue and this knowledge may contribute to thedevelopment of therapy based on host-directed anti-virals (HDAs) with theadditional advantage of imposing a higher genetic barrier of resistance and variabilityamong DENV serotypes (23).