Description: Dynamics of cellular and humoral immune response in PEP recipients exposed to RABV-positive dogs
Data is available showing that the immune response at D14 after a one-week protocol of three sessions of four ID injections at D0, D3 and D7 is comparable to a 5-dose regimen in healthy adults.
The number of doses administered in the one-week, three session protocol, however, remains high at a total of 12 ID doses. Furthermore, some evidence points to rabies virus inhibiting the normal immune response following inoculation by a bite of a rabid animal through suppression of intracellular interferon production by the viral phosphoprotein (Chopy et al., 2011; Ito et al., 2010;
Johnson et al., 2010). Therefore immune response to vaccination in patients bitten by confirmed rabid dogs may in theory differ from healthy subjects. Other vaccine non-responders may include pregnant women, HIV-infected patients and people receiving chloroquine (Taylor et al., 1984).
Goal: Overarching goal
To determine whether the 4th session of the postexposure rabies vaccination protocol is needed.
To assess immune protection after the 3rd injection vs. after the 4th injection in patients, including
those bitten by confirmed rabid dogs.
To assess whether antibody titers are a good proxy for immune protection
To assess clinical outcome after post-exposure prophylaxis after a bite by a confirmed rabid