Immunogenicity Assessment of Subjects Receiving Rabies Post-exposure Prophylaxis in Cambodia

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

215 participants

Study Classification

OBSERVATIONAL

Study Start Date

2020-07-15

Study Completion Date

2022-04-30

Brief Summary

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A rabies virus neutralizing antibody (RVNA) concentration ≥ 0.5 IU/ml at 14 days after immunization is considered a proxy for protection in vaccine efficacy studies. Abridged and dose-sparing vaccination regimens increase accessibility and reduce both direct and indirect costs, especially in resource-constrained countries where RABV prevalence is highest. Several efficacy studies evaluated safety and immunogenicity of abridged regimens in healthy adult volunteers using either four-site intradermal (ID) or intramuscular (IM) regimens, showing them to be safe and immunogenic.

Researchers at the Institut Pasteur du Cambodge (IPC) have previously conducted a retrospective study on clinical outcome at ≥6 months in 3318 Cambodians who received intradermal Vero cell vaccine post-exposure prophylaxis after a bite by a rabid or sick-looking but untested dog in 2003-2014. Here, the investigators could show that there was no significant difference in survival among patients who received 3 versus 4 sessions of the Thai Red Cross (TRC) ID regimen. In a separate study, investigators measured antibody responses in order to evaluate the immunogenicity of the TRC regiment after 3 sessions versus 4 sessions. The investigators did not observe an increase in rabies virus seroneutralization titers 14 days after the fourth immunization compared to 14 days after the third immunization. These results contributed to changes endorsed by the WHO in its April 2018 guidelines. The "Institut Pasteur du Cambodge (IPC) regimen" of three PEP sessions of two-site ID 0.1 mL vaccine doses each at days 0, 3 and 7 is the first one-week PEP regimen to be recommended.

In the current research project, the aim is to compare further different PEP vaccination strategies in a real life setting of individuals attending the rabies vaccination center at Institut Pasteur du Cambodge (IPC) in Phom Penh, Cambodia. The antibody kinetics and cellular immune responses in patients following either the one-week, 2-site ID regimen (IPC regimen) or the two-week IM regimen (4-dose regimen) as well as the participants' survival for both protocols after 6 months are evaluated.

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Detailed Description

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Conditions

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Rabies Post-exposure Prophylaxis

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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IM, <15 years old

Group with Intramuscular (IM) rabies post-exposure prophylaxis

Intramuscular (IM) rabies post-exposure prophylaxis

Intervention Type BIOLOGICAL

one-site, 0.5 mL at Day 0, D3, D7 and D14

IM, 15 years old and older

Group with Intramuscular (IM) rabies post-exposure prophylaxis

Intramuscular (IM) rabies post-exposure prophylaxis

Intervention Type BIOLOGICAL

one-site, 0.5 mL at Day 0, D3, D7 and D14

ID, <15 years old

Group with Intradermal (ID) rabies post-exposure prophylaxis

Intradermal (ID) rabies post-exposure prophylaxis

Intervention Type BIOLOGICAL

two-site, 0.1 mL at Day 0, D3 and D7

ID, 15 years old and older

Group with Intradermal (ID) rabies post-exposure prophylaxis

Intradermal (ID) rabies post-exposure prophylaxis

Intervention Type BIOLOGICAL

two-site, 0.1 mL at Day 0, D3 and D7

Interventions

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Intramuscular (IM) rabies post-exposure prophylaxis

one-site, 0.5 mL at Day 0, D3, D7 and D14

Intervention Type BIOLOGICAL

Intradermal (ID) rabies post-exposure prophylaxis

two-site, 0.1 mL at Day 0, D3 and D7

Intervention Type BIOLOGICAL

Eligibility Criteria

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Inclusion Criteria

* Subjects entering a rabies post-exposure vaccination course whatever the vaccine used with or without administration of rabies immunoglobulin (RIGs).
* Subjects with ability to attend all scheduled visits and to comply with all study procedures