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肌肉注射与皮内注射狂犬病暴露后预防方案的免疫原性并排比较研究:疑似狂犬病病毒暴露个体队列研究。

Side-by-side Comparative Study of the Immunogenicity of the Intramuscular and Intradermal Rabies Post-exposure Prophylaxis Regimens in a Cohort of Suspected Rabies Virus Exposed Individuals.

机构信息

Virology Unit, Institut Pasteur du Cambodge, Pasteur Network, Phnom Penh, Cambodia.

Immunology Unit, Institut Pasteur du Cambodge, Pasteur Network, Phnom Penh, Cambodia.

出版信息

Clin Infect Dis. 2023 Sep 18;77(6):910-916. doi: 10.1093/cid/ciad304.

Abstract

All World Health Organization (WHO) pre-qualified rabies vaccines for humans are inactivated tissue culture rabies virus formulations produced for intramuscular (IM) administration. Due to costs and vaccine shortage, dose-saving intradermal (ID) administration of rabies post-exposure prophylaxis (PEP) is encouraged by WHO. This study compared the immunogenicity of the ID 2-site, 3-visit Institut Pasteur Cambodge (IPC) PEP regimen to the IM 1-site, 4-visit 4-dose Essen regimen using Verorab vaccine (Sanofi). The development of neutralizing antibodies (nAbs) and T cell response was assessed in 210 patients with a category II or III animal exposure in a rabies-endemic country. At day 28, all participants developed nAbs (≥0.5 IU/mL), irrespective of PEP scheme, age, or administration of rabies immunoglobulin. T cell response and nAb titers were similar for both PEP schemes. This study demonstrated that the 1-week ID IPC regimen is as effective as the 2-week IM 4-dose Essen regimen in inducing an anti-rabies immune response under real-life PEP.

摘要

世界卫生组织(WHO)所有预认证的人用狂犬病疫苗均为狂犬病病毒经组织培养灭活后制成的肌肉内(IM)注射制剂。由于成本和疫苗短缺,WHO 鼓励采用节省剂量的皮内(ID)途径进行狂犬病暴露后预防(PEP)。本研究使用赛诺菲公司的 Verorab 疫苗比较了两部位、三访的柬埔寨巴斯德研究所(IPC)PEP 方案与单部位、四访、四剂的 Essen 方案的免疫原性。在一个狂犬病流行国家,对 210 名 II 类或 III 类动物接触者评估了中和抗体(nAbs)和 T 细胞反应的发展情况。在第 28 天,无论 PEP 方案、年龄或狂犬病免疫球蛋白的使用情况如何,所有参与者均产生了 nAbs(≥0.5IU/mL)。两种 PEP 方案的 T 细胞反应和 nAb 滴度相似。这项研究表明,在现实生活中的 PEP 中,1 周 ID IPC 方案与 2 周 IM 4 剂 Essen 方案一样有效,可诱导抗狂犬病免疫应答。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/33d1/10506778/110d4b4a129c/ciad304_ga1.jpg

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