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Although mechanistic details are lacking, two scenarios to explain these observations are favored: Metabolically active intracellular parasites consume oxygen and decrease intracellular pH, both of which promote sickling of AS red cells

Vaccine (2021) 39(8):13108

R.TianL.DengF.SwansonM.et al

No differences were observed regarding H

If side effects persist beyond week 4 or worsen with dose escalation, reduce the dose by 20% and maintain that level for an additional 2 weeks before further increases