Rahimi Pooneh, Vahabpour RouhAllah, Aghasadeghi Mohammad Reza, Sadat Syed Mehdi, Howaizi Nader, Mostafavi Ehsan, Eslamifar Ali, Fallahian Vida
Department of Hepatitis and AIDS, Pasteur Institute, Tehran, Iran.
WHO Collaborating Center for Reference and Research on Rabies, Pasteur Institute, Tehran, Iran.
PLoS One. 2015 Oct 6;10(10):e0139171. doi: 10.1371/journal.pone.0139171. eCollection 2015.
Post exposure prophylaxis using one of the WHO-approved vaccines is the method of choice for preventing rabies. Abnormal immune function in patients with some specific medical conditions, such as pregnancy, chronic hepatitis B virus infection, different types of cancers like lymphoma, diabetes I and II, corticosteroid consumption by patients with rheumatoid arthritis and lupus erythematosus, could impair the immunologic response to various vaccines. The immune response to rabies vaccination has never been examined in patients with any of these described medical conditions. This study purposed to evaluate the neutralyzing antibody response after vaccination with purified Vero cell rabies vaccine (PVRV) according to the WHO-recommended Post-Exposure Prophylaxis (PEP) "ESSEN" regimen.
Thirty healthy volunteers and 50 volunteers with different medical conditions who were exposed to a suspected rabid animal in the 2nd or 3rd category of exposure received 5 doses of PVRV under the ESSEN protocol. Three blood samples were collected on days 0 (before the first dose), 14, and 35. The anti-rabies antibody titer was measured using the Rapid Fluorescent Foci Inhibition Test (RFFIT) and an ELISA Bio-Rad, Platelia, Rabies II kit.
All subjects reached NAb titers above 0.5 IU/ml by day 14 after vaccination. On day 35 (1 week after receiving the last rabies vaccine), anti-rabies antibodies were in the protective level (>0.5 IU/ml) in both groups. There was no statistically significant difference in anti-rabies antibody response due to the type of exposure (category 2 or 3), and successful seroconversion was confirmed in both groups.
In conclusion, the ESSEN protocol using the PVRV vaccine is sufficient for rabies prophylaxis in patients with specific medical conditions.
使用世界卫生组织批准的疫苗之一进行暴露后预防是预防狂犬病的首选方法。某些特定医疗状况患者的免疫功能异常，如妊娠、慢性乙型肝炎病毒感染、不同类型的癌症（如淋巴瘤）、I型和II型糖尿病、类风湿性关节炎和红斑狼疮患者使用皮质类固醇，可能会损害对各种疫苗的免疫反应。从未在患有上述任何一种医疗状况的患者中检测过对狂犬病疫苗的免疫反应。本研究旨在根据世界卫生组织推荐的暴露后预防（PEP）“埃森”方案，评估接种纯化Vero细胞狂犬病疫苗（PVRV）后的中和抗体反应。
30名健康志愿者和50名患有不同医疗状况且在二级或三级暴露中接触过疑似狂犬病动物的志愿者按照埃森方案接种了5剂PVRV。在第0天（第一剂之前）、第14天和第35天采集三份血样。使用快速荧光灶抑制试验（RFFIT）和ELISA Bio-Rad、Platelia、狂犬病II试剂盒测量抗狂犬病抗体滴度。
所有受试者在接种疫苗后第14天达到的中和抗体滴度均高于0.5 IU/ml。在第35天（接种最后一剂狂犬病疫苗后1周），两组的抗狂犬病抗体均处于保护水平（>0.5 IU/ml）。由于暴露类型（二级或三级）导致的抗狂犬病抗体反应无统计学显著差异，两组均确认血清转化成功。
总之，使用PVRV疫苗的埃森方案足以对患有特定医疗状况的患者进行狂犬病预防。
