Feline
immunodeficiency virus (FIV) is an important viral infection of cats that
occurs worldwide.
The virus was first discovered
during the investigation of a disease outbreak in a previously healthy colony
of rescue cats in the USA, that had been showing similar signs to people with
the acquired immunodeficiency syndrome (AIDS) caused by human immunodeficiency
virus (HIV) infection. Although HIV and FIV are very similar, the viruses are
species specific, which means that FIV only infects cats and HIV only infects
humans. Thus there is no risk of infection for people in contact with
FIV-positive cats. Cats are most commonly infected with FIV through bite
wounds. Once infected, a cat will remain infected with the virus for life, and
after a period that may last several years, the virus may damage the cat's
immune response and lead to signs of disease.
What is FIV and how is it spread?
Feline immunodeficiency virus
belongs to the retrovirus family of viruses in a group called lentiviruses.
Lentiviruses typically only cause disease slowly and thus infected cats may
remain healthy for many years.
Once a cat has been infected with
FIV, the infection is virtually always permanent (cats cannot eliminate the
virus), and the virus will be present in the saliva of an infected cat. The
most common way for the virus to be transmitted from one cat to another is via
a cat bite, where saliva cottoning the virus is inoculated under the skin of
another cat. The virus does not survive long in the environment and is readily
killed by common disinfectants. Rarely, the virus may also be spread by
non-aggressive contact between cats (eg, mutual grooming), from a pregnant
queen to her kittens; and it can also be spread through blood transfusions.
It is not known if blood sucking
parasites such as fleas can spread infection so it is wise to maintain a
regular flea control programme.
How does FIV cause disease?
FIV infects cells of the immune
system (white blood cells, mainly lymphocytes). The virus may kill or damage
the cells it infects, or compromise their normal function. This may eventually
cause a gradual decline in the cat's immune function.
In the first few weeks after
infection the virus replicates and may cause mild signs of disease such as a
mild fever and swollen lymph nodes. Usually these signs are so mild they go
unnoticed. An immune response will develop which does not eliminate the virus,
but keeps viral replication at a relatively low level.
After a period of time, in some
infected cats viral replication increases again, and it is typically these cats
that go on to develop signs of disease. In most cases this will probably be
around 2-5 years after the cat was first infected. Increased replication of the
virus leads to progressive damage to the immune system.
How common is FIV infection?
The prevalence (frequency) of FIV
infection varies in different cat populations. It tends to be more common where
cats live in more crowded conditions (and thus where cat fights are more
common) and tends to be much less common where cat populations are low and
where cats are kept mainly indoors. In general, among healthy cats around 1-5%
will be infected with FIV but in high risk cats (for example in cats with signs
of recurrent disease suggesting immunosuppression) the prevalence may be as high
as 15-20%. Infection is much more common in outdoor cats, and is about twice as
common in male cats compared with female cats. Although cats of all ages can be
infected, it is most commonly middle-aged cats (5-10 years of age) where
infection is diagnosed.
What are the clinical signs of an FIV infection?
FIV usually causes disease
through immunosuppression - the normal immune responses of the cat are
compromised, leading to an increased susceptibility to other infections and
diseases. There are no specific signs associated with FIV, but typically
infected cats will develop recurrent bouts of infections or diseases that
gradually get worse over time, and infections may not respond to treatment as
well as would normally be expected.
Some of the most common signs
seen in FIV infected cats are:
·
Weight
loss
·
Recurrent
fever
·
Lethargy
·
Enlarged
lymph nodes
·
Gingivitis and
stomatitis (inflammation of the gums and mouth)
·
Chronic or recurrent
respiratory, ocular and intestinal disease
·
Chronic
skin disease
·
Neurological disease
(in some cats the virus can affect the brain)
Other disease may also develop
such as neoplasia (eg, lymphoma) and other infectious agents may be more
problematic in FIV infected cats (such as toxoplasmosis, haemoplasma
infections, feline infectious peritonitis, etc).
How is FIV diagnosed?
There are several tests available
for diagnosing FIV infection, some of which can easily be performed in your own
vet's clinic. Most tests involve collecting a blood sample and detecting the
presence of antibodies in the against the virus (usually there is not enough
virus in the blood itself to be able to readily detect it).
Antibodies against FIV are
produced by the cat's immune system during infection, and the test works on the
principle that cats cannot eliminate the virus so if antibodies are present in
the blood then the virus will also be present. These tests are generally highly
reliable, but no test is 100% accurate. If there is any doubt about the
validity of the test result, your vet may want to do a follow-up confirmatory
test using a different method (such as a different test kit, or sending blood
to a laboratory to check for antibodies using a more sophisticated assay such
as 'western blotting' or to look for virus using a molecular test such as PCR).
It is important to remember that
kittens born to FIV-infected queens will receive antibodies from the queen via
the milk, and so will test positive early in life though they may not be
infected. Kittens with a positive test result should always be retested when
they are 5-6 months of age. Additionally, in countries where the FIV vaccine is
available (see below), cats that have been vaccinated will also test positive
on the routine antibody tests, so alternatives (such as a PCR test) are needed.
Management options
Many FIV infected cats are able
to live happily with the virus for a long period of time, and indeed the virus
will not necessarily ever cause clinical disease. Whether disease develops
depends on many factors including the strain of FIV a cat is infected with, the
cat's immune response and the presence or absence of other infectious agents.
In one study, FIV-infected cats were found to survive just under 5 years on
average (from the time their disease was diagnosed) compared with about 6 years
for a similar group of non-infected cats.
The main aims of managing an
FIV-infection are to prevent further spread of infection to other cats and to
maintain a good quality of life for the infected cat. Some antiviral
medications used in human patients with HIV infection have also been shown to
help some cats with FIV infection.
General and supportive treatment
should include:
·
Neutering all
FIV-infected cats to reduce the risk of fighting and spreading infection
·
Confining
FIV-positive cats indoors where possible, and keeping them away from
non-infected cats. This helps prevent spread of infection to other cats and
reduces exposure of the FIV-infected cat to other infectious agents
·
Maintaining good
quality nutrition - using a good commercial food and avoiding raw meat, eggs
and unpasteurised dairy products helps reduce the risk of exposure to parasites
and bacteria that might cause disease
·
Maintaining good
routine preventive healthcare (regular flea and worm control, routine
vaccinations etc.)
·
Ideally veterinary
health checks twice yearly - your vet may suggest certain blood tests
occasionally to monitor your cat's health
·
Prompt diagnosis and
appropriate treatment of any secondary or concurrent diseases. Longer courses
of antibiotics may be needed to treat bacterial infections if they are
significantly immunosuppressed.
Two forms of antiviral therapy
are sometimes used in FIV-infected cats:
·
Interferons are a
group of naturally-produced compounds that have anti-viral effects and modify
immune responses. A recombinant feline interferon (feline interferon omega) is
available in some countries and it is possible that using this may have some
helpful anti-viral and immune modulating effects. It is unlikely to have a
profound effect in FIV-infected cats, but your vet may suggest trying this as a
treatment.
·
Antiviral drugs such
as AZT - some of the human antivirus drugs used to treat HIV are also effective
against FIV and can be safe to use (although careful monitoring of cats is
needed). These drugs cannot 'cure' a cat with FIV, but especially if the signs
of disease are quite severe, this may be a form of therapy that your vet will
offer. Treatment is expensive though, and many cats appear to do just as well
with good supportive therapy.
Prevention and control
A vaccine against FIV has been
licensed and is available in a number of countries. The available data suggests
that the vaccine gives a useful degree of protection and that it might
therefore be useful in cats at appreciable risk of being exposed to FIV. The
vaccine cannot be expected to give complete protection though, especially as
there are multiple different strains of FIV. Also, a vaccinated cat will
subsequently test positive on the routinely used antibody tests for FIV
infection (see above).
FIV-infected cats should ideally
be separated from other cats, but this can sometimes be difficult in a multicat
household. As the risk of transmission by social contact such as sharing food
bowls and mutual grooming is low, some owners elect to keep the household as it
is. However, it may be helpful to at least feed cats using separate food bowls,
as large amounts of virus are present in saliva. Litter trays and food bowls
should be disinfected after use to kill the virus.
Advice for breeding colonies
To minimise the risk of introducing
FIV into the colony, breeders should prevent their cats having free access
outdoors, or having contact with cats allowed outdoors. Annual testing of
breeding cats is ideal, but testing any new cats before being introduced to an
FIV-free colony is vital. If any cats test positive for FIV they should be
removed, the colony isolated, and the remaining cats retested after 3-6 months.
Advice for cat rescue centres and organisations
Ideally routine screening should
be performed in all cats before homing but financial constraints mean this is
not always possible. Priority should be given to testing any cats at high risk
(cats showing clinical signs suggesting FIV or aggressive cats). Ideally, cats
in a rehoming facility should be housed separately and, if not, then kept in
the smallest groups possible. Neutering all cats before rehoming will help in
reducing transmission of FIV.
Advice for boarding catteries
Boarding catteries should be
properly constructed and managed so that cats from different households can
never come into contact with each other, or use common exercise areas. In this
situation there is no risk to other cats, and no reason not to board an
FIV-positive cat.
Prognosis for infected cats
The prognosis for FIV-infected
cats is guarded, but depends on the stage of disease. If FIV is diagnosed
early, there may be a long period during which the cat is free of clinical
signs related to FIV, and not all infected cats go on to develop an
immunodeficiency syndrome. Infection is almost invariably permanent, but many
infected cats can be maintained with a good quality of life for extended
periods.
http://www.icatcare.org/advice/cat-health/feline-immunodeficiency-virus-fiv
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