Until today there has only been a single documented case of
PrEP failure in a US Peace Corps volunteer (PCV) in 1983.15,16
The 23-y old female PCV was working in Kenya, where she was
bitten by a puppy, approximately 6 mo after completing a 3-dose
ID PrEP series with Human Diploid Cell Vaccine (HDCV).
Sixty-nine days after the bite she developed symptoms of rabies.
At that time, no rabies virus neutralizing antibodies (VNA) were
detected in her serum, and a sero-survey in other PCVs who
received ID PrEP with the same lot of vaccine showed that 82%
had no detectable VNA titers. An investigation looking at possible
reasons for the poor immune responses could not identify one
single explanation and suggested multifactorial causes, including
immunosuppression by anti-malarial treatment.15 Except for
this single case, with presumably millions of rabies PrEP doses
administered, PrEP has been uniformly demonstrated to be
effective in rabies prevention.
Until today there has only been a single documented case of
PrEP failure in a US Peace Corps volunteer (PCV) in 1983.15,16
The 23-y old female PCV was working in Kenya, where she was
bitten by a puppy, approximately 6 mo after completing a 3-dose
ID PrEP series with Human Diploid Cell Vaccine (HDCV).
Sixty-nine days after the bite she developed symptoms of rabies.
At that time, no rabies virus neutralizing antibodies (VNA) were
detected in her serum, and a sero-survey in other PCVs who
received ID PrEP with the same lot of vaccine showed that 82%
had no detectable VNA titers. An investigation looking at possible
reasons for the poor immune responses could not identify one
single explanation and suggested multifactorial causes, including
immunosuppression by anti-malarial treatment.15 Except for
this single case, with presumably millions of rabies PrEP doses
administered, PrEP has been uniformly demonstrated to be
effective in rabies prevention.
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