title: Neutralizing Antibody Response after Intramuscular Purified Vero Cell Rabies Vaccination (PVRV) in Iranian Patients with Specific Medical Conditions.
abstract: OBJECTIVE
  Post exposure prophylaxis using one of the WHO-approved vaccines is the method of choice for preventing rabies. Abnormal immune function in patients with some specific medical conditions, such as pregnancy, chronic hepatitis B virus infection, different types of cancers like lymphoma, diabetes I and II, corticosteroid consumption by patients with rheumatoid arthritis and lupus erythematosus, could impair the immunologic response to various vaccines. The immune response to rabies vaccination has never been examined in patients with any of these described medical conditions. This study purposed to evaluate the neutralyzing antibody response after vaccination with purified Vero cell rabies vaccine (PVRV) according to the WHO-recommended Post-Exposure Prophylaxis (PEP) "ESSEN" regimen.
  
  
  METHODS
  Thirty healthy volunteers and 50 volunteers with different medical conditions who were exposed to a suspected rabid animal in the 2nd or 3rd category of exposure received 5 doses of PVRV under the ESSEN protocol. Three blood samples were collected on days 0 (before the first dose), 14, and 35. The anti-rabies antibody titer was measured using the Rapid Fluorescent Foci Inhibition Test (RFFIT) and an ELISA Bio-Rad, Platelia, Rabies II kit.
  
  
  RESULTS
  All subjects reached NAb titers above 0.5 IU/ml by day 14 after vaccination. On day 35 (1 week after receiving the last rabies vaccine), anti-rabies antibodies were in the protective level (>0.5 IU/ml) in both groups. There was no statistically significant difference in anti-rabies antibody response due to the type of exposure (category 2 or 3), and successful seroconversion was confirmed in both groups.
  
  
  CONCLUSIONS
  In conclusion, the ESSEN protocol using the PVRV vaccine is sufficient for rabies prophylaxis in patients with specific medical conditions.
authors.affiliation: Department of Hepatitis and AIDS, Pasteur Institute, Tehran, Iran.
authors.forename: Pooneh
authors.initials: P
authors.lastname: Rahimi
authors.affiliation: Department of Hepatitis and AIDS, Pasteur Institute, Tehran, Iran.
authors.forename: RouhAllah
authors.initials: R
authors.lastname: Vahabpour
authors.affiliation: Department of Hepatitis and AIDS, Pasteur Institute, Tehran, Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Aghasadeghi
authors.affiliation: Department of Hepatitis and AIDS, Pasteur Institute, Tehran, Iran.
authors.forename: Syed Mehdi
authors.initials: SM
authors.lastname: Sadat
authors.affiliation: WHO Collaborating Center for Reference and Research on Rabies, Pasteur Institute, Tehran, Iran.
authors.forename: Nader
authors.initials: N
authors.lastname: Howaizi
authors.affiliation: Department of Epidemiology, Pasteur Institute, Tehran, Iran.
authors.forename: Ehsan
authors.initials: E
authors.lastname: Mostafavi
authors.affiliation: Department of Vaccination, Rabies post-exposure prophylaxis, Pasteur Institute, Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Eslamifar
authors.affiliation: Department of Vaccination, Rabies post-exposure prophylaxis, Pasteur Institute, Tehran, Iran.
authors.forename: Vida
authors.initials: V
authors.lastname: Fallahian
mesh_terms: D000328:Adult; D000818:Animals; D057134:Antibodies, Neutralizing / Q000276:immunology*; D002522:Chlorocebus aethiops; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D008875:Middle Aged; D056990:Post-Exposure Prophylaxis; D011819:Rabies Vaccines / Q000276:immunology*; D014709:Vero Cells
chemical_list: D057134:Antibodies, Neutralizing; D011819:Rabies Vaccines