Публикације и научни радови Пастеровог завода…
ИСТРАЖИВАЊА
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2024 |
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Banović, Pavle; Mijatović, Dragana; Simin, Verica; Vranješ, Nenad; Meletis, Eleftherios; Kostoulas, Polychronis; Obregon, Dasiel; Cabezas-Cruz, Alejandro Real-world evidence of rabies post-exposure prophylaxis in Serbia: Nation-wide observational study (2017–2019) Journal Article In: Travel Medicine and Infectious Disease, 2024. Садржај | Линкови | BibTeX | Ознаке: immunization, Rabies, seroconversion, vaccine @article{nokey, Background Rabies remains a deadly zoonotic disease, primarily prevalent in Eastern European countries, with a significant global burden in Asia and Africa. Post-exposure prophylaxis (PEP) is critical to prevent clinical rabies. Serbia, a country with a relatively low animal rabies incidence, has been implementing a 4-dose Essen PEP regimen for 13 years. This real-world study aimed to assess the effectiveness of the 4-dose Essen regimen, considering demographic and clinical factors, after WHO Category III exposure. Method The study included 601 patients who received the 4-dose Essen PEP and 79 who received an additional 5th dose. Results Age emerged as a critical factor influencing seroconversion rates after the 4-dose regimen, with older individuals exhibiting lower RVNA titers. Logistic regression indicated a 3.18% decrease in seroconversion odds for each added year of age. The Cox proportional hazards mixed model highlighted age-related risks, with age groups 45–60 and 75–92 at the highest risk of non-seroconversion. Human Rabies Immune Globulin (HRIG) administration was associated with lower RVNA values after the 4-dose regimen, suggesting interference with vaccine immunogenicity among people who received larger doses of HRIG. Conclusions This study provides valuable real-world evidence for rabies PEP in a non-homogeneous population with potential comorbidities. The results underscore the importance of optimizing PEP strategies, particularly in older individuals, and reconsidering HRIG dosing to improve seroconversion rates. |