Antibody-dependent Enhancement of Infection and the Pathogenesis of Viral Disease

Clin Infect Dis. 1994 Sep;19(3):500-12. doi: 10.1093/clinids/19.3.500.


Antibody-dependent enhancement of infection (ADE) is an in vitro serological phenomenon--or a group of phenomena--in which viral infection of susceptible cells is modified by the addition of virus-reactive antibody. Evidence suggests that ADE reflects immunologic processes that occur in vivo. Various severe and even fatal viral conditions of humans and animals, including dengue shock syndrome, the "early-death phenomenon" in experimental infections of immune animals, and other vaccine- and immunoglobulin-modified conditions, have been attributed to ADE by some researchers. ADE has caused great concern in relation to the development of vaccines against dengue virus and human immunodeficiency virus. More data are urgently needed on the mechanisms and determinants of ADE and on its alleged role in disease pathogenesis and in vaccine-associated phenomena.

Publication types

  • Historical Article
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Age Factors
  • Animals
  • Antibodies, Viral / immunology
  • Antibodies, Viral / physiology*
  • Child
  • Dengue / epidemiology
  • Dengue / history
  • Dengue / immunology*
  • Dengue Virus / pathogenicity
  • HIV Infections / immunology
  • History, 20th Century
  • Humans
  • Risk Factors
  • Viral Vaccines / administration & dosage
  • Viral Vaccines / pharmacology
  • Virus Diseases / immunology*
  • Virus Diseases / mortality


  • Antibodies, Viral
  • Viral Vaccines