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March 28, 2001

Postexposure Rabies Prophylaxis in Immunosuppressed Patients—Reply

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorJody W.ZylkeMD, Contributing EditorIndividualAuthor

JAMA. 2001;285(12):1574-1575. doi:10.1001/jama.285.12.1574

In Reply: We agree with Drs Gibbons and Rupprecht that the term "acceptable antibody titer" is preferable to "protective." The Israel Ministry of Health adopted the World Health Organization recommendations for an acceptable antirabies antibody titer of 0.5 IU/mL. It is true that blood specimens collected 2 to 4 weeks after PEP should reveal a neutralizing antibody titer. However, the recommendations of the ACIP indicate that in immunosuppressed persons, seroconversion should be detected after the third dose.1 There is no recommendation regarding the acceptable level of seroconversion in such cases.

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