Feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV) infections occur in cats worldwide. Both infections are associated with a variety of clinical symptoms and can affect quality of life and longevity.
This document is an update of the 2008 Feline Retroviral Management Guidelines issued by the American Association of Feline Practitioners and represents the current understanding of the pathogenesis, diagnosis, prevention, and treatment of feline retroviral infections.
Testing and interpretation:
Although vaccines against FeLV are available in many countries and against FIV in some countries, identifying infected cats remains an important factor in preventing new infections. The retrovirus status of any cat at risk of infection should be known. Cats should be tested as soon as possible after purchase, after contact with an infected cat or a cat of unknown infection status, prior to vaccination against FeLV or FIV, and whenever clinical disease develops. It may not be possible to determine a cat’s infection status using tests at a single point in time; repeat testsusing different methods may be required. Although FeLV and FIV infections can be associated with clinical illness, some infected cats, particularly those infected with FIV, can live for many years with a good quality of life.
Dealing with infected cats:
There is little data evaluating treatments for infected cats, particularly antiretroviral and immunomodulatory drugs. Management of infected cats focuses on effective preventive health strategies and prompt detection and treatment of disease and limiting the spread of infection.
introduction
Feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV) are among the most common causes of infectious diseases in cats and are found worldwide. A large observational study evaluated FeLV and FIV test results over a 9-year period from 2008 to 2016. 1 Data was collected from a reference laboratory database containing results from cats field-tested using point-of-care (POC) testing. Almost 3 million test results from 68 countries grouped in seven world regions were analyzed
A 2006 survey of over 18,000 cats in the US and Canada found that 2.3% of cats were positive for FeLV antigen and 2.5% of cats were positive for FIV antibodies. In 2009, a survey of over 11,000 cats in Canada found prevalences of 3.4% for FeLV antigen and 4.3% for FIV antibody. Another large study in 2010 evaluated the results of FeLV antigen and FIV antibody test results from over 62,000 cats from veterinary clinics and shelters in the United States and Canada.
In this study, the prevalence for FeLV antigen and FIV antibody was 3.1% and 3.6%, respectively. A prospective study in Europe testing cats attending a veterinary facility from September 2016 to March 2017 for salivary FeLV RNA as a measure of antigenemia found an overall prevalence of 2.3%. The highest prevalence was in southern Europe (5.5%) and the lowest in northern Europe (0.7%). These studies show that although infection prevention guidelines have been in place for decades, there is a need to improve adherence to testing and vaccination recommendations.
Pathogenesis and consequences of infection
Feline Leukemia Virus Infection
Transmission of feline leukemia virus
FeLV is transmitted through close contact between cats. Generally, it is transmitted vertically and horizontally from infected queens to their kittens, and horizontally between cohabiting or feuding cats. There is an age-related increase in resistance to FeLV infection; Kittens are at the highest risk of becoming progressively infected. However, some studies have shown effective natural and experimental infection in adult cats.
Pathogenesis of feline leukemia virus
Progressively infected cats shed infectious viruses in body fluids, including saliva, nasal discharge, milk, urine, and feces. Cats typically acquire FeLV via the oral route, but can also become infected through bite wounds. After virus exposure via the oronasal route, FeLV can first be found in the local lymphoid tissues; then it spreads to the periphery via monocytes and lymphocytes (primary viremia; see “Terminology” on page 24). During this primary viremia, the virus can infect the bone marrow. Secondary viremia can occur after bone marrow infection, in which FeLV-containing leukocytes and platelets appear in the blood, resulting in the virus being detectable by an immunofluorescent antibody (IFA) test.
Results after exposure to feline leukemia virus
Based on molecular methods, the possible consequences of infection after FeLV exposure have been redefined. episodes of FeLV infection are now classified as abortive infection (comparable to the earlier “regressor cats”), regressive infection (comparable to the earlier “latent infection”, with or without prior “transient viremia”) and progressive infection ( comparable to the earlier „persistent viremia“). The probability of each result depends on the infection pressure and the cat’s immune status and has been described in experimental infections with certain pathogen-free cats.
Historically, exposure to FeLV has been reported to result in abortive infection in 20-30% of cats, regressive infection in 30-40% of cats, and progressive infection in 30-40% of cats. However, large field studies testing simultaneously for p27 antigen, proviral DNA, viral RNA and virus-neutralizing antibodies have identified a higher proportion of cats suspected of having neutralizing antibodies based on a pattern of negative antigen and PCR testing abortive infections have occurred. In a study of 495 domestic cats in Germany, 4% were classified as having an abortive infection, 2% as progressive and 1% as regressive.In a study of 440 domestic cats in Australia, 11% were classified as presumptively abortive, 2% as presumptively regressive, and 0.5% as presumably progressive.
This suggests that abortive infection may be the most common outcome after exposure under typical conditions. In contrast, in two populations of cats in Australia (a group of 38 cats and a group of 51 cats) in which FeLV-infected and uninfected cats were mixed without separating healthy from clinically ill cats, 9% were considered abortive classified infection, 25% as regressive and 21% as progressive, suggesting that infection resistance can be compromised by intense infection pressure, comorbidities, and a stressful environment.
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Viral RNA is normally detectable in plasma by real-time reverse transcriptase-polymerase chain reaction (qRT-PCR) assays within 1 week of FeLV exposure, followed by proviral DNA detection by PCR within 2 weeks of exposure, and finally by FeLV- Antigen detection, which usually occurs after 30 days but may take longer in some cats. Not only cats with progressive infection go through the early stages, but also some cats with regressive infection. These regressively infected cats have similar proviral and plasmaviral RNA loads in their peripheral blood early in infection; However, unlike cats with progressive infection, their viral load decreases to undetectable levels over time.