a GSK Vaccines , Wavre , Belgium.
b Department of Tropical Pediatrics, Faculty of Tropical Medicine , Mahidol University , Bangkok , Thailand.
Expert Rev Vaccines. 2018 Jun;17(6):525-545. doi: 10.1080/14760584.2018.1473765. Epub 2018 Jun 25.
Fifteen million people each year receive post-exposure prophylaxis (PEP) to prevent rabies, yet the disease remains neglected and highly under-reported.
In this systematic literature review, we assessed the immunogenicity, efficacy, and safety of a purified chick embryo cell-culture rabies vaccine (PCECV) for PEP against rabies by intramuscular (IM) or intradermal (ID) administration. We performed meta-analyses to compare immunogenicity according to the route of vaccine administration, study population, and PEP regimen, such as number of doses, and concomitant rabies immunoglobulin.
There were 54 estimates of immune responses to vaccination, which showed that in the overall population, after starting PEP with PCECV by the IM or ID route (≥2.5 IU per dose), almost all individuals had rabies virus neutralizing antibody (RVNA) titers above the World Health Organization (WHO) recommended serological threshold for an adequate immune response to vaccination (RVNA ≥0.5 IU/ml by day 14). In the overall population, PCECV had an acceptable safety profile. However, given that there are 59,000 human rabies deaths reported annually, the challenge is to improve access to PCECV for PEP against human rabies.
每年有 1500 万人接受暴露后预防（PEP）以预防狂犬病，但该病仍被忽视且报告率极低。
在这项系统文献回顾中，我们评估了纯化鸡胚细胞培养狂犬病疫苗（PCECV）通过肌内（IM）或皮内（ID）给药用于 PEP 预防狂犬病的免疫原性、疗效和安全性。我们进行了荟萃分析，以根据疫苗给药途径、研究人群和 PEP 方案（如剂量数和同时使用狂犬病免疫球蛋白）比较免疫原性。
共有 54 项关于疫苗接种免疫反应的评估，结果表明，在总体人群中，通过 IM 或 ID 途径（每剂≥2.5IU）开始 PEP 后，几乎所有个体的狂犬病病毒中和抗体（RVNA）滴度均高于世界卫生组织（WHO）建议的疫苗接种充分免疫反应的血清学阈值（RVNA≥0.5IU/ml 在第 14 天）。在总体人群中，PCECV 具有可接受的安全性特征。然而，鉴于每年报告有 59000 人死于人类狂犬病，挑战在于改善 PCECV 在人类狂犬病 PEP 中的可及性。
