Moulenat Thomas, Petit Céline, Bosch Castells Valérie, Houillon Guy
Université Claude Bernard Lyon 1, Institut des Sciences Pharmaceutiques et Biologiques (ISPB)-Faculté de Pharmacie de Lyon, 69008 Lyon, France.
Sanofi Pasteur, 14 Espace Henry Vallée, 69007 Lyon, France.
Trop Med Infect Dis. 2020 Mar 7;5(1):40. doi: 10.3390/tropicalmed5010040.
The purified Vero cell rabies vaccine (PVRV; Verorab, Sanofi Pasteur) has been used in rabies prevention since 1985. Evolving rabies vaccination trends, including shorter intradermal (ID) regimens with reduced volume, along with WHO recommendation for ID administration has driven recent ID PVRV regimen assessments. Thus, a consolidated review comparing immunogenicity of PVRV ID regimens during pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) is timely and beneficial in identifying gaps in current research. A search of seven databases for studies published from 1985 to November 2019 identified 35 studies. PrEP was assessed in 10 studies (n = 926) with 1-3-site, 1-3-visit regimens of up to 3-months duration. Seroconversion (rabies virus neutralizing antibodies [RVNA] ≥ 0.5 IU/mL) rates of 90-100% were reported within weeks, irrespective of regimen, with robust booster responses at 1 year (100% seroconversion rates by day 14 post-booster). However, data are lacking for the current WHO-recommended, 2-site, 1-week ID PrEP regimen. PEP was assessed in 25 studies (n = 2136) across regimens of 1-week to 90-day duration. All ID PEP regimens assessed induced ≥ 99% seroconversion rates (except in HIV participants) by day 14-28. This review confirms ID PVRV suitability for rabies prophylaxis and highlights the heterogeneity of use in the field.
纯化的Vero细胞狂犬病疫苗（PVRV；Verorab，赛诺菲巴斯德公司）自1985年以来一直用于狂犬病预防。狂犬病疫苗接种趋势不断演变，包括剂量减少的更短皮内（ID）接种方案，以及世界卫生组织对ID接种的推荐，推动了近期对ID PVRV接种方案的评估。因此，进行一项综合综述，比较暴露前预防（PrEP）和暴露后预防（PEP）期间PVRV ID接种方案的免疫原性，对于识别当前研究中的差距是及时且有益的。检索七个数据库，查找1985年至2019年11月发表的研究，共识别出35项研究。在10项研究（n = 926）中评估了PrEP，采用1 - 3个部位、1 - 3次就诊的方案，持续时间长达3个月。无论接种方案如何，数周内报告的血清转化率（狂犬病病毒中和抗体[RVNA]≥0.5 IU/mL）为90 - 100%，1年后有强劲的加强反应（加强后第14天血清转化率达100%）。然而，目前世界卫生组织推荐的2部位、1周ID PrEP方案的数据尚缺乏。在25项研究（n = 2136）中评估了PEP，涉及1周至90天的接种方案。到第14 - 28天，所有评估的ID PEP方案诱导的血清转化率均≥99%（HIV感染者除外）。本综述证实了ID PVRV适用于狂犬病预防，并突出了该领域使用的异质性。
