Low-dose interferon-alpha treatment for feline immunodeficiency virus infection

Feline immunodeficiency virus sustains an AIDS-like syndrome in cats, which is considered a relevant model for human AIDS. Under precise enrolment requirements, 30 naturally infected cats showing overt disease were included in a trial of low-dose, oral human interferon-alpha treatment. Twenty-four of them received 10 IU/Kg of human interferon-alpha and 6 placebo only on a daily basis under veterinary supervision. The low-dose human interferon-alpha treatment significantly prolonged the survival of virus-infected cats (p<0.01) and brought to a rapid improvement of disease conditions in the infected hosts. Amelioration of clinical conditions was neither correlated with plasma viremia, nor with proviral load in leukocytes. A good survival of CD4+ T cells and a slow increase of CD8+ T cells were also observed in human interferon-alpha-treated cats. Interestingly, the improvement of the total leukocyte counts showed a much stronger correlation with the recovery from serious opportunistic infections. As shown in other models of low-dose interferon-alpha treatment, there was a rapid regression of overt immunopathological conditions in virus-infected cats. This hints at a major role of interferon-alpha in the control circuits of inflammatory cytokines, which was probably the very foundation of the improved clinical score and survival despite the unabated persistence of virus and virus-infected cells.     

The variability of serological and molecular diagnosis of feline immunodeficiency virus infection

Diagnosis of feline immunodeficiency virus (FIV) infection by polymerase chain reaction (PCR) has recently become available, but little is known about the performance of this assay. The purpose of this study was to determine the sensitivity and specificity of PCR diagnosis of FIV infection. Replicate aliquots of blood samples from cats identified as FIV positive or negative by 2 previous enzyme-linked immunosorbent assay (ELISA) results, and from clinically healthy dogs, were submitted to different laboratories for FIV serologic diagnosis and PCR. The PCR products obtained in 1 laboratory were sequenced to determine the FIV subtype. The PCR assays correctly identified 100%, 80%, and 50% of the FIV-positive samples, and 100%, 90%, and 70% of FIV-negative samples. Each dog sample was reported as FIV PCR positive at least once, and FIV subtypes A, B, and C were identified. It was concluded that PCR tests currently available for FIV infection are unreliable, with highly variable sensitivity and specificity.     

Clinical aspects of feline immunodeficiency and feline leukemia virus infection

Feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV) are retroviruses with a global impact on the health of domestic cats. The two viruses differ in their potential to cause disease. FIV can cause an acquired immunodeficiency syndrome that increases the risk of developing opportunistic infections, neurological diseases, and tumors. In most naturally infected cats, however, FIV itself does not cause severe clinical signs, and FIV-infected cats may live many years without any health problems. FeLV is more pathogenic, and was long considered to be responsible for more clinical syndromes than any other agent in cats. FeLV can cause tumors (mainly lymphoma), bone marrow suppression syndromes (mainly anemia) and lead to secondary infectious diseases caused by suppressive effects of the virus on bone marrow and the immune system. Today, FeLV is less important as a deadly infectious agent as in the last 20 years prevalence has been decreasing in most countries.     

Epizootiologic association between feline immunodeficiency virus infection and feline leukemia virus seropositivity

Five hundred twenty-one feline serum samples submitted to the Texas Veterinary Medical Diagnostic Laboratory between Nov 1, 1988, and Jan 31, 1989 were tested for antibody to feline immunodeficiency virus (FIV) by use of an ELISA. The prevalence of FIV infection in this population was 11.3% (95% confidence interval: 8.6 to 14.0%). Serologic test results for FeLV were available for 156 of the 521 cats. A significant (P = 0.008) association between FIV infection and FeLV seropositivity was observed; FeLV-positive cats were nearly 4 times more likely to be seropositive for FIV than were FeLV-negative cats. The association remained statistically significant (P = 0.021) after adjusting for age and gender, using multiple-logistic regression analysis.     

Comparison and interpretation of diagnostic tests for feline immunodeficiency virus infection.

Feline sera were submitted to the Cornell Feline Health Center (n = 497) or to the New York State Diagnostic Laboratory (n = 1,565) for feline immunodeficiency virus (FIV) testing. Some sera (n = 166) were submitted for confirmation of previous FIV-positive results; 151 of these sera had been tested at the referring veterinary practice or laboratory, using an in-house ELISA. Excluding the samples submitted for confirmation, a total of 173 samples (9.1%) were FIV-positive; 11.6% of the clinically ill or high-risk cats and 0.49% of the healthy, low risk cats were positive for FIV antibody. A commercially available ELISA for detection of antibody to FIV was evaluated in relation to the immunofluorescent antibody (IFA) test and the immunoblot assay. The ELISA was interpreted according to the manufacturer's instructions, with the ratio of sample optical density to positive control optical density (S/P) determining a positive or negative result. The ELISA results based on the S/P interpretation were compared with a kinetics-based (KELA) interpretation of the ELISA. The KELA values were reported as positive, negative, or equivocal. Using the immunoblot as the standard, ELISA (S/P interpretation) had sensitivity of 0.93 and specificity of 0.98, whereas the IFA test had sensitivity of 0.95 and specificity of 0.98. However, the sensitivity and specificity of the ELISA (S/P interpretation) were markedly reduced for sample results falling in the KELA equivocal range, indicating that equivocal results were valid interpretations for some sera. A high number (22.5%) of the samples submitted for confirmation of a positive result from use of the in-house ELISA were determined to be negative for FIV antibody.(ABSTRACT TRUNCATED AT 250 WORDS)     

Quality of different in-clinic test systems for feline immunodeficiency virus and feline leukaemia virus infection

Many new diagnostic in-house tests for identification of feline immunodeficiency virus (FIV) and feline leukaemia virus (FeLV) infection have been licensed for use in veterinary practice, and the question of the relative merits of these kits has prompted comparative studies. This study was designed to define the strengths and weaknesses of seven FIV and eight FeLV tests that are commercially available. In this study, 536 serum samples from randomly selected cats were tested. Those samples reacting FIV-positive in at least one of the tests were confirmed by Western blot, and those reacting FeLV-positive were confirmed by virus isolation. In addition, a random selection of samples testing negative in all test systems was re-tested by Western blot (100 samples) and by virus isolation (81 samples). Specificity, sensitivity, positive and negative predictive values of each test and the quality of the results were compared.     

Accuracy of polymerase chain reaction assays for diagnosis of feline immunodeficiency virus infection in cats

OBJECTIVE: To determine the sensitivity, specificity, and overall diagnostic accuracy of polymerase chain reaction (PCR) assays offered by commercial diagnostic laboratories for diagnosis of FIV infection in cats. DESIGN: Prospective clinical trial. ANIMALS: 124 cats. PROCEDURE: Blood was collected from cats that were neither infected with nor vaccinated against FIV, uninfected cats that were vaccinated with a licensed FIV vaccine, and cats experimentally and naturally infected with FIV representing subtypes A, B, and C. Coded blood samples were submitted to 3 laboratories in the United States and Canada offering PCR assays for diagnosis of FIV infection to veterinary practitioners. All laboratories tested fresh blood samples, and 1 laboratory also tested samples submitted as dried blood smears. The FIV infection status in all cats was confirmed by virus isolation. Sensitivity, specificity, and correct results were calculated for each PCR assay. RESULTS: Sensitivity ranged from 41% to 93%. Specificity ranged from 81% to 100% in unvaccinated cats and 44% to 95% in cats vaccinated against FIV. Correct results were obtained in 58% to 90% of 124 cats tested. All tests misidentified both uninfected and infected cats. False-positive results by all laboratories were higher in cats vaccinated against FIV than in unvaccinated cats, suggesting that vaccination interferes with the performance or interpretation of PCR assays used for diagnosis of FIV infection. CONCLUSIONS AND CLINICAL RELEVANCE: PCR assays used for diagnosis of FIV infection presently marketed to veterinary practitioners in North America vary significantly in diagnostic accuracy and did not resolve the diagnostic dilemma resulting from vaccination of cats against FIV.     

Use of western blot and radioimmunoprecipitation for diagnosis of feline leukemia and feline immunodeficiency virus infections.

The uses and limitations of the western blot (WB) and radioimmunoprecipitation assay (RIPA) techniques for study of feline immunodeficiency virus (FIV) and FeLV were evaluated. Western blot analysis was used to detect antigenic relatedness between the 2 lentiviruses. Using a rabbit serum directed against p26 of the equine infectious anemia virus (EIAV) and anti-EIAV horse serum obtained from an infected horse, cross-reactivity with p24 of FIV was revealed. Cat sera obtained late after experimentally induced FIV infection recognized p26 of EIAV, which indicates reciprocal cross-reactivity. For RIPA, FIV was metabolically labeled, and virus-coded proteins were identified, using immunoprecipitation. Polypeptides with apparent molecular mass of about 15, 24, 43, 50, 120, and 160 kilodaltons were detected. An additional polypeptide of 10 kilodaltons was found only by use of WB analysis.     

Clinical and pathological findings in feline immunodeficiency virus experimental infection.

A study is described of the clinical and pathological findings in 20 specific pathogen free cats infected when 1 year old with feline immunodeficiency virus and monitored over 12 months. Cats were divided into two groups (A and B). The clinical and clinicopathological features were studied in Group A. In Group B, at 1, 2, 4, 9 and 12 months post infection two cats were necropsied. Clinically all cats developed generalised lymphadenopathy, six cats were neutropenic and five cats lymphopenic. Three cats became febrile with conjunctivitis and anterior uveitis and one of these cats ultimately developed jaundice. Postmortem examinations confirmed a generalised lymphadenopathy involving peripheral and visceral lymph nodes with concurrent stimulation of splenic white matter and mucosal lymphoid tissue of the digestive tract and conjunctiva. Within the lymph nodes there was a reactive follicular hyperplasia accompanied by a paracortical hyperplasia with an increased paracortical vascularity. Unusual features were the presence of lymphoid follicles in the bone marrow, thymus and parathyroid tissue. In addition, aggregates of lymphoid cells were found within salivary glands, kidneys, sclera and choroid of the eye. One cat developed a lymphosarcoma affecting the liver and kidneys at 36 weeks post infection. The cat with jaundice had a cholangitis with marked biliary epithelial hyperplasia.     

Detection of feline immunodeficiency virus infection in bone marrow of cats.

Natural or experimental feline immunodeficiency virus (FIV) infection in cats is often associated with hematologic abnormalities which are similar to those observed in human immunodeficiency virus (HIV) infected patients. To determine if cells in bone marrow are infected with FIV and whether severity of hematopoietic disorder is correlated with the level of viral infection, bone marrow tissues from ten experimentally and two naturally FIV infected cats were examined by in situ hybridization for presence of FIV RNA. Seven of the 12 FIV infected cats were also naturally or experimentally coinfected with feline leukemia virus (FeLV). FIV RNA was detected mainly in megakaryocytes and unidentified mononuclear cells in the bone marrow of cats that were sick and had marrow hypercellularity and immaturity. These included all cats in the acute phase of FIV infection and two of seven long term FIV infected cats. One long term FIV infected cat with lymphosarcoma was also positive for FIV RNA in bone marrow cells. The other four long term FIV infected cats were relatively healthy, with normal bone marrow morphology, and were negative for FIV infected cells. Bone marrow from three non-infected and two cats infected with FeLV alone were also negative for FIV RNA by in situ hybridization. We concluded that megakaryocytes and mononuclear cells were targets of the viral infection and that the presence of FIV RNA in cells of the bone marrow correlated with marrow hypercellularity and immaturity, and severity of illness.     

Feline leukemia virus and feline immunodeficiency virus.

Ophthalmic manifestations of FeLV or FIV infection can occur in all ocular tissues and may be manifestations of direct viral effects or secondary to viral-related malignant transformation. Additionally, the manifestations of common feline ophthalmic pathogens may be more severe and poorly responsive to therapy because of the immunosuppressive effects of FeLV or FIV infection. Prompt diagnosis of underlying viral infection in cats with ophthalmic disease is paramount for accurate diagnosis and prognosis and is required for appropriate therapeutic decision making.     

Husbandry practices for cats infected with feline leukemia virus or feline immunodeficiency virus.

Cats that are persistently infected with FeLV or feline immunodeficiency virus but are not manifesting clinical signs of disease are at risk for developing a wide variety of immunosuppressive, degenerative, or neoplastic diseases. Infected cats should be isolated to prevent transmission of virus to healthy cats, and to protect infected cats from exposure to pathogens that can cause life-threatening secondary infections. Iatrogenic transmission of virus from infected cats in isolation to healthy cats may be reduced by strict adherence to handling, sanitation, and disinfection procedures. Husbandry practices that may delay the complications of infection include regular vaccination, provision of high-quality diets, reduction of stress, control of endoparasites and ectoparasites, and early and aggressive treatment of clinical signs of disease.     

Comparison of six in-house tests for the rapid diagnosis of feline immunodeficiency and feline leukaemia virus infections

Six rapid tests for the diagnosis of feline immunodeficiency virus (FIV) and feline leukaemia virus (FeLV) infections which have recently been introduced in Europe for use in small animal practice were compared. Eight hundred serum samples were tested and those reacting FIV-positive in at least one of the tests were confirmed by Western blot, and those reacting FeLV-positive were confirmed by virus isolation. The specificity and sensitivity of each test and the quality of the results produced were compared.     

Enzyme-linked immunosorbent assay methods for detection of feline leukemia virus and feline immunodeficiency virus.

Enzyme-linked immunosorbent assays have been widely used for diagnosis of FeLV and feline immunodeficiency virus (FIV) infections. Various ELISA kits for FeLV are available from several manufacturers. Although these tests are configured in a variety of formats, they are all direct antigen-detection systems for the viral core protein p27. On the other hand, ELISA for FIV exposure detects specific feline antibody to FIV. Basic immunoassay principles and the application of ELISA technology used in FeLV and FIV ELISA kits are described.     

Use of tears for diagnosis of feline leukemia virus infection

A comparison was made of the use of serum, tears, and saliva for the detection of feline leukemia virus (FeLV) infection in cats. Cotton swabs were used to collect saliva, and tear-test strips were used to collect tears. Specimens were analyzed by a commercially available ELISA. Using a 10- to 15-minute specimen incubation period, FeLV was detected in 70% of the saliva specimens and in 73% of the tear specimens from viremic (serum-positive) cats. Feline leukemia virus antigen was not detected in saliva and tear specimens from serum-negative cats. The sensitivity of the tear assay was improved by increasing the incubation time to 24 hours. Tear strips could be air-dried and stored at room temperature for up to 7 days without any appreciable loss of activity. Client-owned and experimentally infected laboratory cats were tested for FeLV, using air-dried tear-test strips and a 24-hour incubation period. Tears were positive (contained FeLV antigen) in 65 of 72 (90%) serum-positive cats and did not contain antigen in 46 of 46 (100%) serum-negative cats. Results of ELISA obtained from serum and tears also were compared with results obtained from indirect fluorescent antibody testing of blood smears. Results of indirect fluorescent antibody and ELISA compared favorably with each other and with the results of tear testing.