Similar to earlier observations,25,49 a trend of an antagonistic
epistatic effect between heterozygote -thalassemia and HbAS
was found. A tendency toward higher susceptibility was detected
between heterozygote -thalassemia and HbAC also
supporting the hypothesis that protection against malaria by
HbAS and HbAC is mediated by different mechanisms. Because
of the low number of persons heterozygous for both the -globin
deletion and for the HbS or HbC mutation (23 and 27,
respectively), these results were not robust and need to be
interpreted with appropriate caution.