Equivalence between pre-exposure schemes for human rabies and evaluation of the need for serological monitoring
Autor(a) principal: | |
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Data de Publicação: | 2010 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | por eng |
Título da fonte: | Revista de Saúde Pública |
Texto Completo: | https://www.revistas.usp.br/rsp/article/view/32801 |
Resumo: | OBJECTIVE: To evaluate the humoral immune response to the pre-exposure schedule of human rabies vaccination through intradermal and intramuscular routes, as well as the need for serological monitoring. METHODS: A randomized and controlled intervention study was carried out in São Paulo, Southeastern Brazil, from 2004-2005. There were 149 volunteers, of which 127 completed the vaccination schedule (65 intradermal and 62 intramuscular) and underwent humoral immune response evaluation at ten, 90 and 180 days post-vaccination. Two outcomes were considered for comparing the two routes of administration: the geometric average of neutralizing antibody titers and the proportion of individuals with satisfactory titers (>; 0.5 IU/mL) at each evaluation point. The association of the humoral immune response with anthropometric and demographic data was analyzed through a normal distribution test and a chi-square test with a Yates correction. After completion of the vaccination schedule, the proportion of seropositive results was compared by the Kruskall Wallis test, and the average titers were compared by variance analysis. RESULTS: the average antibody titers were higher in patients who were vaccinated intramuscularly. The percentage of volunteers with satisfactory titers (>; 0.5% IU/mL) decreased over time in both groups. However, in the group vaccinated intradermally the rate of satisfactory titers on day 180 ranged from 20% to 25%, while the intramuscular route varied from 63% to 65%. An association between the humoral immune response and the demographic and anthropometric variables was not observed. CONCLUSIONS: Serology after the third dose can be considered unnecessary in unexposed patients, since 97% and 100% of volunteers respectively vaccinated by the intradermal and intramuscular route presented satisfactory antibody levels (>; 0.5% IU/mL). |
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Equivalence between pre-exposure schemes for human rabies and evaluation of the need for serological monitoring Equivalencia y evaluación de la necesidad de serología de control entre esquemas de pre-exposición a la rabia humana Equivalência e avaliação da necessidade de sorologia de controle entre esquemas de pré-exposição à raiva humana Vacinas Anti-Rábicas^i1^simunoloSerologiaImunidade HumoralEstudos de IntervençãoRaiva^i1^sprevenRaiva^i1^scontrVacunas Antirrábicas^i3^sinmunoloSerologíaInmunidad HumoralEstudios de IntervenciónRabia^i3^sprevencRabia^i3^scontRabies Vaccines^i2^simmunolSerologyImmunityHumoralIntervention StudiesRabies^i2^spreventRabies^i2^scont OBJECTIVE: To evaluate the humoral immune response to the pre-exposure schedule of human rabies vaccination through intradermal and intramuscular routes, as well as the need for serological monitoring. METHODS: A randomized and controlled intervention study was carried out in São Paulo, Southeastern Brazil, from 2004-2005. There were 149 volunteers, of which 127 completed the vaccination schedule (65 intradermal and 62 intramuscular) and underwent humoral immune response evaluation at ten, 90 and 180 days post-vaccination. Two outcomes were considered for comparing the two routes of administration: the geometric average of neutralizing antibody titers and the proportion of individuals with satisfactory titers (>; 0.5 IU/mL) at each evaluation point. The association of the humoral immune response with anthropometric and demographic data was analyzed through a normal distribution test and a chi-square test with a Yates correction. After completion of the vaccination schedule, the proportion of seropositive results was compared by the Kruskall Wallis test, and the average titers were compared by variance analysis. RESULTS: the average antibody titers were higher in patients who were vaccinated intramuscularly. The percentage of volunteers with satisfactory titers (>; 0.5% IU/mL) decreased over time in both groups. However, in the group vaccinated intradermally the rate of satisfactory titers on day 180 ranged from 20% to 25%, while the intramuscular route varied from 63% to 65%. An association between the humoral immune response and the demographic and anthropometric variables was not observed. CONCLUSIONS: Serology after the third dose can be considered unnecessary in unexposed patients, since 97% and 100% of volunteers respectively vaccinated by the intradermal and intramuscular route presented satisfactory antibody levels (>; 0.5% IU/mL). OBJETIVO: Evaluar la respuesta inmune humoral del esquema de pre-exposición de la rabia humana realizado por las vías intramuscular e intradérmica y la necesidad de serología de control. MÉTODOS: Estudio de intervención controlado y aleatorio, realizado en Sao Paulo, Sureste de Brasil, en 2004-2005. Fueron reclutados 149 voluntarios, de los cuales 127 (65 intradérmica y 62 intramuscular) completaron el esquema de vacunación y realizaron evaluación de la respuesta inmune humoral 10, 90 y 180 días posterior al término de la vacunación. Fueron considerados dos resultados para la comparación entre las dos vías de aplicación: el promedio geométrico del título de anticuerpos neutralizantes y la proporción de individuos con títulos satisfactorios (>; 0,5 UI/mL) en cada momento de la evaluación. Fue analizada la asociación de la respuesta humoral con datos antropométricos y demográficos por medio de prueba de medias y chi-cuadrado con corrección de Yates. Posterior a la conclusión del esquema fueron realizadas la comparación de la proporción de seropositivos por la prueba de Kruskall Wallis y la comparación de los títulos promedios por análisis de varianza. RESULTADOS: Los títulos promedios de anticuerpos fueron mayores en los individuos que recibieron las vacunas por vía intramuscular. El porcentaje de voluntarios con títulos satisfactorios (>; 0,5 UI/mL) disminuyó con el tiempo en ambos grupos, sin embargo, en el grupo que recibió vacuna por vía intradérmica la proporción de títulos satisfactorios en el día 180 varió de 20% a 25%, mientras que por la vía intramuscular varió de 63% a 65%. No se observó asociación de la respuesta inmune humoral con las variables demográficas o antropométricas. CONCLUSIONES: La serología posterior a la tercera dosis puede ser considerada innecesaria en individuos bajo control con respecto a la exposición, una vez que 97% y 100% de los voluntarios vacunados, respectivamente por vía intradérmica y por la vía intramuscular, presentaron niveles de anticuerpos satisfactorios (>; 0,5 UI/mL). OBJETIVO: Avaliar a resposta imune humoral do esquema de pré-exposição da raiva humana realizado pelas vias intramuscular e intradérmica e a necessidade de sorologia de controle. MÉTODOS: Estudo de intervenção controlado e randomizado, realizado em São Paulo, SP, em 2004-2005. Foram recrutados 149 voluntários, dos quais 127 (65 intradérmica e 62 intramuscular) completaram o esquema de vacinação e realizaram avaliação da resposta imune humoral dez, 90 e 180 dias após o término da vacinação. Foram considerados dois desfechos para a comparação entre as duas vias de aplicação: a média geométrica do título de anticorpos neutralizantes e a proporção de indivíduos com títulos satisfatórios (>; 0,5 UI/mL) em cada momento de avaliação. Foi analisada a associação da resposta humoral com dados antropométricos e demográficos por meio de teste de médias e qui-quadrado com correção de Yates. Após a conclusão do esquema foram feitas a comparação da proporção de soropositivos pelo teste de Kruskall Wallis e a comparação dos títulos médios por análise de variância. RESULTADOS: Os títulos médios de anticorpos foram maiores nos indivíduos que receberam as vacinas por via intramuscular. A percentagem de voluntários com títulos satisfatórios (>; 0,5 UI/mL) diminuiu com o tempo em ambos os grupos, porém, no grupo que recebeu as vacinas por via intradérmica, a proporção de títulos satisfatórios no dia 180 variou de 20% a 25%, enquanto pela via intramuscular variou de 63% a 65%. Não se observou associação da resposta imune humoral com as variáveis demográficas ou antropométricas. CONCLUSÕES: A sorologia após a terceira dose pode ser considerada desnecessária em indivíduos sob controle quanto à exposição, uma vez que 97% e 100% dos voluntários vacinados, respectivamente por via intradérmica e pela via intramuscular, apresentaram níveis de anticorpos satisfatórios (>; 0,5 UI/mL). Universidade de São Paulo. Faculdade de Saúde Pública2010-06-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://www.revistas.usp.br/rsp/article/view/3280110.1590/S0034-89102010005000005Revista de Saúde Pública; Vol. 44 No. 3 (2010); 548-554 Revista de Saúde Pública; Vol. 44 Núm. 3 (2010); 548-554 Revista de Saúde Pública; v. 44 n. 3 (2010); 548-554 1518-87870034-8910reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USPporenghttps://www.revistas.usp.br/rsp/article/view/32801/35310https://www.revistas.usp.br/rsp/article/view/32801/35311Copyright (c) 2017 Revista de Saúde Públicainfo:eu-repo/semantics/openAccessCunha, Ricardo SiqueiraSilva, Andréa de Cássia Rodrigues daBatista, Alexandre MendesChaves, Luciana BotelhoBarata, Rita Barradas2012-07-10T02:21:52Zoai:revistas.usp.br:article/32801Revistahttps://www.revistas.usp.br/rsp/indexONGhttps://www.revistas.usp.br/rsp/oairevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2012-07-10T02:21:52Revista de Saúde Pública - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Equivalence between pre-exposure schemes for human rabies and evaluation of the need for serological monitoring Equivalencia y evaluación de la necesidad de serología de control entre esquemas de pre-exposición a la rabia humana Equivalência e avaliação da necessidade de sorologia de controle entre esquemas de pré-exposição à raiva humana |
title |
Equivalence between pre-exposure schemes for human rabies and evaluation of the need for serological monitoring |
spellingShingle |
Equivalence between pre-exposure schemes for human rabies and evaluation of the need for serological monitoring Cunha, Ricardo Siqueira Vacinas Anti-Rábicas^i1^simunolo Serologia Imunidade Humoral Estudos de Intervenção Raiva^i1^spreven Raiva^i1^scontr Vacunas Antirrábicas^i3^sinmunolo Serología Inmunidad Humoral Estudios de Intervención Rabia^i3^sprevenc Rabia^i3^scont Rabies Vaccines^i2^simmunol Serology Immunity Humoral Intervention Studies Rabies^i2^sprevent Rabies^i2^scont |
title_short |
Equivalence between pre-exposure schemes for human rabies and evaluation of the need for serological monitoring |
title_full |
Equivalence between pre-exposure schemes for human rabies and evaluation of the need for serological monitoring |
title_fullStr |
Equivalence between pre-exposure schemes for human rabies and evaluation of the need for serological monitoring |
title_full_unstemmed |
Equivalence between pre-exposure schemes for human rabies and evaluation of the need for serological monitoring |
title_sort |
Equivalence between pre-exposure schemes for human rabies and evaluation of the need for serological monitoring |
author |
Cunha, Ricardo Siqueira |
author_facet |
Cunha, Ricardo Siqueira Silva, Andréa de Cássia Rodrigues da Batista, Alexandre Mendes Chaves, Luciana Botelho Barata, Rita Barradas |
author_role |
author |
author2 |
Silva, Andréa de Cássia Rodrigues da Batista, Alexandre Mendes Chaves, Luciana Botelho Barata, Rita Barradas |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Cunha, Ricardo Siqueira Silva, Andréa de Cássia Rodrigues da Batista, Alexandre Mendes Chaves, Luciana Botelho Barata, Rita Barradas |
dc.subject.por.fl_str_mv |
Vacinas Anti-Rábicas^i1^simunolo Serologia Imunidade Humoral Estudos de Intervenção Raiva^i1^spreven Raiva^i1^scontr Vacunas Antirrábicas^i3^sinmunolo Serología Inmunidad Humoral Estudios de Intervención Rabia^i3^sprevenc Rabia^i3^scont Rabies Vaccines^i2^simmunol Serology Immunity Humoral Intervention Studies Rabies^i2^sprevent Rabies^i2^scont |
topic |
Vacinas Anti-Rábicas^i1^simunolo Serologia Imunidade Humoral Estudos de Intervenção Raiva^i1^spreven Raiva^i1^scontr Vacunas Antirrábicas^i3^sinmunolo Serología Inmunidad Humoral Estudios de Intervención Rabia^i3^sprevenc Rabia^i3^scont Rabies Vaccines^i2^simmunol Serology Immunity Humoral Intervention Studies Rabies^i2^sprevent Rabies^i2^scont |
description |
OBJECTIVE: To evaluate the humoral immune response to the pre-exposure schedule of human rabies vaccination through intradermal and intramuscular routes, as well as the need for serological monitoring. METHODS: A randomized and controlled intervention study was carried out in São Paulo, Southeastern Brazil, from 2004-2005. There were 149 volunteers, of which 127 completed the vaccination schedule (65 intradermal and 62 intramuscular) and underwent humoral immune response evaluation at ten, 90 and 180 days post-vaccination. Two outcomes were considered for comparing the two routes of administration: the geometric average of neutralizing antibody titers and the proportion of individuals with satisfactory titers (>; 0.5 IU/mL) at each evaluation point. The association of the humoral immune response with anthropometric and demographic data was analyzed through a normal distribution test and a chi-square test with a Yates correction. After completion of the vaccination schedule, the proportion of seropositive results was compared by the Kruskall Wallis test, and the average titers were compared by variance analysis. RESULTS: the average antibody titers were higher in patients who were vaccinated intramuscularly. The percentage of volunteers with satisfactory titers (>; 0.5% IU/mL) decreased over time in both groups. However, in the group vaccinated intradermally the rate of satisfactory titers on day 180 ranged from 20% to 25%, while the intramuscular route varied from 63% to 65%. An association between the humoral immune response and the demographic and anthropometric variables was not observed. CONCLUSIONS: Serology after the third dose can be considered unnecessary in unexposed patients, since 97% and 100% of volunteers respectively vaccinated by the intradermal and intramuscular route presented satisfactory antibody levels (>; 0.5% IU/mL). |
publishDate |
2010 |
dc.date.none.fl_str_mv |
2010-06-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/32801 10.1590/S0034-89102010005000005 |
url |
https://www.revistas.usp.br/rsp/article/view/32801 |
identifier_str_mv |
10.1590/S0034-89102010005000005 |
dc.language.iso.fl_str_mv |
por eng |
language |
por eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/32801/35310 https://www.revistas.usp.br/rsp/article/view/32801/35311 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2017 Revista de Saúde Pública info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2017 Revista de Saúde Pública |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf application/pdf |
dc.publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
dc.source.none.fl_str_mv |
Revista de Saúde Pública; Vol. 44 No. 3 (2010); 548-554 Revista de Saúde Pública; Vol. 44 Núm. 3 (2010); 548-554 Revista de Saúde Pública; v. 44 n. 3 (2010); 548-554 1518-8787 0034-8910 reponame:Revista de Saúde Pública instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Revista de Saúde Pública |
collection |
Revista de Saúde Pública |
repository.name.fl_str_mv |
Revista de Saúde Pública - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
revsp@org.usp.br||revsp1@usp.br |
_version_ |
1800221790991024128 |