Our data show that protective effects of HbAS against
parasitemia, mild malaria, and anemia already exist in very
young children and are probably mediated by an inhibition of
parasite growth and multiplication, or by the innate removal by
the spleen of a proportion of the circulating parasite population
after each multiplication cycle. It can be concluded that a
general health advantage for these children starts in the first
months of life. Obviously, the advantage mediated by the HbAC
variant acts differently and may rather be specific for mechanisms
associated with cerebral malaria. The results demonstrate
that the survival advantage mediated by 2 different amino acid
exchanges at the same position of the -globin gene may be the
result of different pathophysiologic mechanisms.