Tags

Type your tag names separated by a space and hit enter

Suppressant effect of human or equine rabies immunoglobulins on the immunogenicity of post-exposure rabies vaccination under the 2-1-1 regimen: a field trial in Indonesia. MAS054 Clinical Investigator Group.
Bull World Health Organ. 1998; 76(5):491-5.BW

Abstract

WHO's reference protocol for post-exposure rabies vaccination advises five intramuscular injections on days 0, 3, 7, 14, and 30; in addition, rabies immunoglobulins (RIG) must be given to serious cases of exposure (grade III severity). Some studies indicate that these immunoglobulins suppress the immunogenicity of rabies vaccine when administered according to an alternative protocol of four injections (2-1-1) on days 0, 7, and 21, which was therefore not recommended for grade III exposures. To test this effect, we conducted a multicentre study in Indonesia using three groups of subjects. One group received only the Vero-cell rabies vaccine (PVRV, Verorab, usual commercial lot) according to the 2-1-1 schedule. The second and third groups received the same schedule of PVRV, plus either equine rabies immunoglobulins (ERIG, 40 IU/kg body weight) or human rabies immunoglobulins (HRIG, 20 IU/kg body weight). Our results confirmed the immunoglobulin suppressant effect, which was more pronounced with human than equine immunoglobulins. In both groups receiving immunoglobulins, the seroconversion rates did not reach 100% on day 28 and the geometric mean antibody titre was lower. Thus, WHO's recommendation in 1992 of the reference protocol plus immunoglobulins for severe cases is substantiated by these results in Indonesian subjects. If the 2-1-1 regimen is chosen by the treating physician and immunoglobulins are indicated, preference should be given to purified equine RIG, which also costs less than human RIG.

Authors+Show Affiliations

Vector-borne Diseases, R & D Medical Department, Pasteur Mérieux Connaught, Lyon, France.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Controlled Clinical Trial
Journal Article
Multicenter Study

Language

eng

PubMed ID

9868840

Citation

Lang, J, et al. "Suppressant Effect of Human or Equine Rabies Immunoglobulins On the Immunogenicity of Post-exposure Rabies Vaccination Under the 2-1-1 Regimen: a Field Trial in Indonesia. MAS054 Clinical Investigator Group." Bulletin of the World Health Organization, vol. 76, no. 5, 1998, pp. 491-5.
Lang J, Simanjuntak GH, Soerjosembodo S, et al. Suppressant effect of human or equine rabies immunoglobulins on the immunogenicity of post-exposure rabies vaccination under the 2-1-1 regimen: a field trial in Indonesia. MAS054 Clinical Investigator Group. Bull World Health Organ. 1998;76(5):491-5.
Lang, J., Simanjuntak, G. H., Soerjosembodo, S., & Koesharyono, C. (1998). Suppressant effect of human or equine rabies immunoglobulins on the immunogenicity of post-exposure rabies vaccination under the 2-1-1 regimen: a field trial in Indonesia. MAS054 Clinical Investigator Group. Bulletin of the World Health Organization, 76(5), 491-5.
Lang J, et al. Suppressant Effect of Human or Equine Rabies Immunoglobulins On the Immunogenicity of Post-exposure Rabies Vaccination Under the 2-1-1 Regimen: a Field Trial in Indonesia. MAS054 Clinical Investigator Group. Bull World Health Organ. 1998;76(5):491-5. PubMed PMID: 9868840.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Suppressant effect of human or equine rabies immunoglobulins on the immunogenicity of post-exposure rabies vaccination under the 2-1-1 regimen: a field trial in Indonesia. MAS054 Clinical Investigator Group. AU - Lang,J, AU - Simanjuntak,G H, AU - Soerjosembodo,S, AU - Koesharyono,C, PY - 1998/12/30/pubmed PY - 1998/12/30/medline PY - 1998/12/30/entrez SP - 491 EP - 5 JF - Bulletin of the World Health Organization JO - Bull World Health Organ VL - 76 IS - 5 N2 - WHO's reference protocol for post-exposure rabies vaccination advises five intramuscular injections on days 0, 3, 7, 14, and 30; in addition, rabies immunoglobulins (RIG) must be given to serious cases of exposure (grade III severity). Some studies indicate that these immunoglobulins suppress the immunogenicity of rabies vaccine when administered according to an alternative protocol of four injections (2-1-1) on days 0, 7, and 21, which was therefore not recommended for grade III exposures. To test this effect, we conducted a multicentre study in Indonesia using three groups of subjects. One group received only the Vero-cell rabies vaccine (PVRV, Verorab, usual commercial lot) according to the 2-1-1 schedule. The second and third groups received the same schedule of PVRV, plus either equine rabies immunoglobulins (ERIG, 40 IU/kg body weight) or human rabies immunoglobulins (HRIG, 20 IU/kg body weight). Our results confirmed the immunoglobulin suppressant effect, which was more pronounced with human than equine immunoglobulins. In both groups receiving immunoglobulins, the seroconversion rates did not reach 100% on day 28 and the geometric mean antibody titre was lower. Thus, WHO's recommendation in 1992 of the reference protocol plus immunoglobulins for severe cases is substantiated by these results in Indonesian subjects. If the 2-1-1 regimen is chosen by the treating physician and immunoglobulins are indicated, preference should be given to purified equine RIG, which also costs less than human RIG. SN - 0042-9686 UR - https://www.unboundmedicine.com/medline/citation/9868840/Suppressant_effect_of_human_or_equine_rabies_immunoglobulins_on_the_immunogenicity_of_post_exposure_rabies_vaccination_under_the_2_1_1_regimen:_a_field_trial_in_Indonesia__MAS054_Clinical_Investigator_Group_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/9868840/ DB - PRIME DP - Unbound Medicine ER -