Safety and Immunogenicity of Preexposure Rabies Vaccination in Children Infected with Human Immunodeficiency Virus Type 1

There has been an alarming increase in the number of HIV-infected children worldwide [1]. Dog bites are a serious public health problem in developing countries, and one-fourth of children in Thailand have experienced animal bites [2]. We conducted this study to evaluate the safety and immunogenicity of rabies vaccine in children infected with HIV type 1 (HIV-1). HDCV (human diploid-cell rabies vaccine, lot 0544, antigen content of 9.3 IU/mL; Institut Merieux, Lyon, France) was given to 13 HIV-1-infected children (study group) and 9 healthy children (control group) as 1 injection of 1 mL into deltoid muscle on days 0, 7, and 28. All subjects were seen on days 0, 7, 14, 21, 28, 60, 90, 180, and 360. Blood was drawn for determination of titers of rabies-neutralizing antibody by the rapid fluorescent focus inhibition test [3] on days 0, 7, 14, 21, 28, 60, 90, 180, and 360. The CD4+ cell count was measured for every subject on day 0 by use of an automated flow cytometer (FACSORT; Becton Dickinson, Cockeysville, MD).