Rabies Neutralizing Antibody Level in Immunosuppressed Patients After Receive of Rabies Post-Exposure Prophylaxis

AUTHORS

Vida Fallahian , * , Ali Eslamifar 3 , Mohammad Amin Fayaz 4 , Parisa Mashayekhi 2 , Peyvand Biglari 1

3 Department of Clinical Research, Pasteur Institute of Iran, Tehran, IR Iran

4 Student of Veterinary Faculty of Tehran University, Tehran, IR Iran

2 Prevention and Treatment of Rabies Center, Department of Vaccination, Pasteur Institute of Iran, Tehran, IR Iran

1 WHO Collaborating Center for Reference and Research on Rabies, Pasteur Institute of Iran, Tehran, IR Iran

How to Cite: Fallahian V, Eslamifar A, Fayaz M A, Mashayekhi P, Biglari P. Rabies Neutralizing Antibody Level in Immunosuppressed Patients After Receive of Rabies Post-Exposure Prophylaxis, Arch Clin Infect Dis. Online ahead of Print ; 6(3):124-7.

ARTICLE INFORMATION

Archives of Clinical Infectious Diseases: 6 (3); 124-7
Article Type: Brief Report

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Abstract

Introduction: Rabies is a fatal disease and has a threatening risk for the public health. Immunosuppression is related to a wide variety of diseases. It is recommended that immunosuppressed patients receive the full post-exposure vaccination, concerning that the immune response may be inadequate. The aim of this study is to determine the level of rabies neutralizing antibody in immunosuppressed patients after receiving rabies post-exposure prophylaxis. Consequently we assess the efficiency of antibody level in immunosuppressed patients admitted at Pasteur Institute of Iran.

The study was performed at Pasteur Institute of Iran. Data related to immunosuppressed patients, doses of anti-rabies vaccine and serum, and level of rabies neutralizing antibody titer collected from the patients admitted to the Prevention and Treatment of Rabies Center, Department of Vaccination at Pasteur Institute of Iran, during 2008 to 2010. Subjects who received chemotherapy, immunosuppressive drugs, and chronic renal failure were included in this study.

Results: Twenty two cases were evaluated. The Immunosuppressed state was related to cancer (in 8 cases), 4 cases of hematologic disorders, 6 cases of autoimmune disease, and 4 cases of chronic renal failure or kidney transplant. Mean age of 46.45 21.5 year. All cases received HRIG serum (human rabies immunoglobulin) plus PVRV (Purified Vero cell rabies vaccine). The level of rabies neutralizing antibody was checked two weeks after the last dose of vaccine. Mean level of rabies neutralizing antibody was 12.07 6.72 IU/ml. All cases achieved minimum protective level of antibody which is ? 0.5 IU/ml. The amount of the antibody level had no relation to age or kind of immunosuppressive disease of patients.

Conclusion: It is recommended that Rabies-exposed immunosuppressed patients receive rabies post exposure prophylaxes. We have to be cautious about the cases who have not achieved the appropriate level of rabies antibody.

Keywords

Post-exposure rabies prophylaxis, Immunosuppressed patients, Rabies neutralizing antibody

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