Failure of pre- and postexposure rabies vaccinations in a child infected with HIV.
We report the case of a 6-y-old HIV-infected girl with severe immune deficiency who failed to respond to intramuscular pre-exposure rabies vaccination using human diploid cell rabies vaccine on days 0, 7 and 28. She also failed to respond to an intradermal postexposure rabies regimen using purified verocell rabies vaccine at 4 sites on days 0, 3 and 7 and at 2 sites on days 30 and 90 (double the usual regimen). Sequentially monitored rabies neutralizing antibody titers were below the WHO minimum acceptable level (> 0.15 IU/ml) in all specimens. Rabies prevention in HIV-infected persons with severe immune suppression requires further study.
Pancharoen
C
C
Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. chadapanch@usa.net
Thisyakorn
U
U
Tantawichien
T
T
Jaijaroensup
W
W
Khawplod
P
P
Wilde
H
H
D000818:Animals; D000914:Antibodies, Viral / Q000097:blood*; D002648:Child; D004285:Dogs; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D011818:Rabies / Q000517:prevention & control*; D011819:Rabies Vaccines / Q000008:administration & dosage* / Q000276:immunology; D011820:Rabies virus / Q000276:immunology*; D014611:Vaccination
D000914:Antibodies, Viral; D011819:Rabies Vaccines