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Summary

Introduction

In Colombia there are few studies that have identified the prevalence of
immunodeficiency virus and feline leukemia virus in cats, especially in the
department of Risaralda. There are no previous investigations, which represents a
major obstacle in approaching to this problem.

Objective

The objective of this study was to determine the prevalence of VLFe and FIV viruses
in samples of cats referred to the EjeLab® Pereira laboratory.

Materials and methods

A retrospective observational study was conducted in which samples of cats referred


to the EjeLab® Pereira laboratory in order to be analyzed for VLFe and VIF between
April 2017 and April 2018. Associable variable tests were performed to identify the
risk factors related to infection on both viruses.

Results

The prevalence for the feline immunodeficiency virus was 21.4% (66/308) and for the
feline leukemia virus was 24.3% (75/308). In addition, there was a coinfection of
9.1% (28/308). Infection with FIV was greater in male cats (30.9%) (p <0.001) and in
adults (28.9%) (p <0.001). Similarly for VLFe, which the infection was higher in males
(28.6%) (p <0.05) and in adults (28.9%) (p <0.05). As for coinfections, these were
more present in male cats (12.9%) (p <0.01).

Conclusions
The prevalences of immunodeficiency and feline leukemia, found in the present work,
are among the highest reported so far. Prevention and epidemiological surveillance
programs are needed to limit the impact of these infectious diseases on the feline
population.

Keywords
Cat diseases, Epidemiology, Immunoassay.

Introduction
Immunodeficiency and Feline Leukemia viruses have gained special importance in
recent years in the field of veterinary medicine, since they are among the diseases
that affect domestic cats the most (1). Both of these viruses represent the main
causes of feline morbidity and mortality, with a global distribution (1). Several studies
have been able to identify both viruses in countries of Asia, Oceania, Europe and
America, both in pets and in street cats (2) (3) (4) (5).

On one hand, FIV is a lentivirus that causes feline immunodeficiency syndrome,


which generates a predisposition for cats to acquire other infections by affecting their
immune system. The signs that appear are stomatitis, gingivitis, peaks of fever,
among others, (3) and are usually caused by opportunistic pathogens, neoplasms or
myelosuppression (6) (7).

While VLFe, is a gamma-retrovirus, which is considered more pathogenic than FIV


(8), the progressive infection can cause tumors, suppression of the bone marrow,
immunosuppression and neurological problems (7) (9). However, in both cases,
symptoms may occur months or years after the initial infection (4), this is why their
medical approach is difficult in some situations.
As for feline leukemia, transmission is quite simple, and occurs horizontally through
contact with nasal gold secretions, urine or contaminated stool. Also, through daily
activities such as playing, mutual grooming and even sharing food and sand
containers. Likewise, from mother to child during pregnancy or lactation (10) (11).
Although its capacity for infection is high, this virus does not have the capacity to
survive for long periods of time on dry surfaces in the environment, so its
transmission through fomites is unlikely (11).

Some studies have recognized the infection as predisposing factors by both viruses,
full males, its access to domestic cats in the street and the low health conditions of
the animal and the environment (1) (2). Likewise, the incidence of VLFe and VIF is
related to animal density (13).

The prevalence of Feline Leukemia virus in developed countries varies between 3%


and 6% (2) (5) (12), while in underdeveloped countries, the prevalence rates range
from 3% to 31%, since these have worse sanitary conditions, little control over pets
and few prevention programs (8) (14) (15). On the other hand, the prevalence of FIV
in developed countries have rates between 2% and 25% (12) (16) (17) and in
developing countries between 2% and 21% (18) (19) (20).

According to data from the National Ministry of Health, by December 2016, the feline
population in Colombia reached 1,523,696 cats and 51,815 in the department of
Risaralda alone, representing 3.4% of the total cat population (21). However, in
Colombia, there are few previous studies that identify the prevalence of these viruses
in cats, especially in the department of Risaralda, in which there are no previous
investigations, which represents a major obstacle in the approach of this problem.

According to the above, it is necessary to carry out these studies, which will let us
know the current epidemiological situation of both viruses, both in monoinfection and
coinfection, in order to develop strategies, whether intervention or prevention, that
seeks to reduce the impact of these diseases in both animal and public health.
For this reason, a retrospective observational study was conducted to establish the
prevalence of VLFe and FIV viruses in cats, whose samples were sent to the
veterinary laboratory EjeLab Pereira® during the period of April 2017 and April 2018;
In addition, variables related to the infection were analyzed.
The importance of this research is based on the contribution of new scientific
knowledge, since there are no previous studies that describe the prevalence of
leukemia and feline immunodeficiency viruses in cats in our region, which may be
useful in the treatment of both pathologies in street and domestic cats. Consequently,
it is a support material for the Veterinarian when evaluating and making decisions
focused on animal welfare.

Feline leukemia virus is a gamma-retrovirus that was initially described in 1964


during research developed in Scotland, where tissues of mesenteric, spleen and
thymus masses were analyzed from animals that had developed the disease
symptomatically (22 ). On the other hand, the feline immunodeficiency virus is a
lentivirus discovered in 1986, in a research developed in California, USA, with cats
that presented symptoms similar to those of an immunodeficiency syndrome (23).
Due to the importance of both viruses and taking into account that they have different
characteristics, it is necessary to address them individually.

Initially, thanks to molecular characterization methods, it has been found that the FIV
virus has six classified genetic subtypes of F-A and one described only in New
Zealand (24) (25). Subtypes A-B have a worldwide distribution, compared to the
others, since they have been found in North America, Europe and Japan (26).
Genotype C has been found in Canada, Taiwan and Vietnam (27) (28), D has been
described in Japan (29) and E in Argentina (30). Finally, the F genotype has been
identified in Portugal (31). The feline immunodeficiency virus has tropism by T cells,
macrophages, dendritic cells and cells of the central nervous system (13), and is
characterized by a persistent infection that causes a decrease mainly of CD4 + T
lymphocytes, and a simultaneous spread in lymphoid organs and cells of the nervous
system, generating a subsequent immunosuppression and a state of susceptibility to
opportunistic agents (26)

Infection by FIV has been classified in several stages, beginning with the acute
phase, where clinical symptoms such as fever, gingivitis, leukopenia, lethargy,
stomatitis, gastrointestinal problems, neutropenia, respiratory diseases and
generalized lymphadenopathy may occur (32) (33). ). In this first stage, presented in
the first days post infection, the VIF replicates in the dendritic cells, macrophages
and CD4 + lymphocytes, being possible to detect it 2 weeks after the infection in the
plasma. The most infected cats have an increase in CD8 + lymphocytes, together
with a strong humoral response, which allows them to control the initial phase of the
infection (34). Accordingly, antibodies to FIV can be found 2-4 weeks after infection
in the blood plasma (13).
The next phase, or asymptomatic phase, varies in duration, but usually is several
years; in this stage, there are no clinical signs and viral replication is controlled by the
immune system, however, there is a decrease in CD4 + / CD8 + lymphocytes (13).
Among the factors that influence the duration of this asymptomatic phase, we can
find the pathogenicity of the infecting strain, the exposure to opportunistic pathogens
and the age of the cat at the time of infection (35).

In the final phase or the feline immunodeficiency syndrome, the symptoms that
appear are infections caused by opportunistic agents, cutaneous diseases such as
demodicosis or pediculosis, neoplasms such as B-cell lymphosarcoma or squamous
cell carcinoma, myelosuppression and neurological alterations. Chronic
gingivostomatis is the most common clinical sign in infected cats and considerably
affects the quality of life of animals (13) (32). FIV is transmitted horizontally through
infected saliva that penetrates deep wounds caused by bites; and vertically from
mother to child during pregnancy or lactation (12). Similarly, intrauterine transmission
can cause arrest of fetal development, abortions, puppies with low birth weight and
deficient in T cells, but generally asymptomatic (36). However, it is rare for mothers to
infect their offspring, which may be due to the nature of the virus, because as
described above, only a high viral load occurs a few weeks after infection. After the
acute stage of infection, the plasma antibody titer increases, circulating viral antigens
become undetectable and vertical transmission becomes unlikely (37). Among the
risk factors for the transmission of this disease, we can find non-castration,
adulthood, being male and having access to the street in the case of domestic cats
(38), while in the protective factors, we find castration and a homemade lifestyle (39).
For FIV diagnosis, there are several methods that can be performed such as ELISA,
immunochromatography, PCR, virus isolation and Western Blot test. Generally,
ELISA and immunochromatography tests are used to detect antibodies against FIV
because of the speed and safety of the diagnosis (8), since we find tests such as the
SNAP FIV / FeLV Combo Plus with 95% sensitivity and 99% specificity (40) and the
Anigen Rapid FIV / FeLV with 96.8% and 99.6% sensitivity and specificity
respectively (41).
Some results obtained may be false positives when analyzing cats under 6 months,
since they may be identifying maternal antibodies. On the other hand, another false
positive can occur between vaccine antibodies and post-infection antibodies, since
the tests can not differentiate them (39).
As for false negatives, these may be due to early stages of infection, since cats
usually take between 2 and 4 weeks post infection to develop antibodies specific for
FIV, although some may take from 6 months to 1 year. False negatives can also
occur in terminal phases of the disease where antibody titers are greatly diminished
or in rapidly progressing diseases, where there is no time for antibodies to form (42).

Finally, those tests with negative results in cats that were potentially exposed to the
virus should be repeated at least 60 days later (39).
Similarly, the results can be confirmed by PCR or Western Blot test, bearing in mind
that PCR can produce doubtful results due to the great genetic variability of the virus,
a low viral load during a long period of infection or a bad preparation of the test (13).
The vaccine against FIV is used as a preventive method, which induces a rapid
humoral response by the immune system. However, because its efficacy is still
controversial, since it has had contradictory results in different studies, the World
Association of Small Animal Veterinarians (WSAVA) has declared it a non-essential
vaccine, and it is recommended only in cats with high risk of contracting the disease
(43).
One of the problems with the vaccine is that it is difficult to distinguish the antibodies
generated by a natural infection and those of vaccination, which is difficult when
making the diagnosis (44). However, some studies have successfully distinguished
antibodies from natural infections and vaccinations (6). Currently there is no vaccine
availability against FIV in Latin America.
Worldwide, the ranges of virus prevalence vary between regions. In North America,
for example, a joint study conducted in Canada and the United States found a
prevalence of 3.6% (2), and another developed only in Canada had a prevalence of
2.2% (12). Research conducted in Europe found prevalence of 3% in Germany (16)
and 11.4% in the United Kingdom (5). At the Asian level, prevalence of 10% and 23%
were found in Malaysia and Japan respectively (7) (45). As for Oceania, the
prevalence ranges from 13.7% to 25%, according to studies carried out in Australia
and New Zealand (4) (17) (46).

In Latin America, most studies have been conducted in Brazil, with prevalences of
10.1% in the southern region of the country, 6% in the Northeast region and 12.5% in
the Midwest (8) (3) (14) . Likewise, in Argentina, one research showed a prevalence
of 21.45% and another study in Mexico of 2.5% (18) (19). Finally, in Colombia
studies have been conducted in three different regions of the country. In Monteria, a
prevalence of 1.6% was found, in Bogotá 11.4% and in Antioquia 6.98% (15) (20)
(47). For its part, the Feline Leukemia virus is a gamma-retrovirus considered more
pathogenic than FIV, responsible for the majority of disease-related deaths and
causing more clinical syndromes than any other agent in cats, as it causes greater
immunosuppression of the host (35). Like the feline immunodeficiency virus, several
subtypes of the VLFe have been identified, classified into FeLV-A, FeLV-B, FeLV-C
and FeLV-T, which are defined by their spectrum of host cells and by the sequence
of nucleotides of the env gene (48). Subtype A is related to immunosuppression. In
addition to being more disseminated and involved in all clinical infections, it can
cause lymphomas. Only subtype A is contagious and of horizontal transmission
between cats (13). Subtype B arises from the recombination of FeLV-A and is
associated with tumors. Subtype C is considered the most pathogenic and arises
from the env gene mutation and is associated with non-regenerative anemia. The last
subtype is called FeLV-T due to its tropism by T lymphocytes (48). Infection with the
Feline Leukemia virus has been classified in several stages, beginning with an initial
state called abortive infection, where the virus begins to replicate in the local
lymphoid tissue of the gold pharynx area. Immunocompetent cats achieve control of
replication through an effective humoral and cell-mediated immune response. These
cats never become viremic, although they are unlikely to completely eradicate the
VLFe virus from their infected cells (32). This phase of abortive infection is likely to
occur when the cat is exposed to low doses of the virus (49).

In the second stage or regressive infection, after infection, the virus is systematically
spread through lymphocytes and infected monocytes, but it is effectively controlled
by the immune system in a matter of months or weeks. This is known as transient
viremia and during this stage cats can expel the virus through saliva, as well as test
positive for antigens in the plasma, while controlling the infection (39).
If the viremia persists for more than three weeks, the cells of the bone marrow
become infected, causing the affected hematopoietic cells to become infected
granulocytes which travel throughout the body. However, most immunocompetent
cats manage to control viraemia, although the virus is not completely eradicated from
the organism since the genetic information of this is found in the cells of the bone
marrow. This stage is known as latent infection and cats do not transmit VLFe, in
addition to giving negative results to antigen detection tests after 16 weeks after
infection (32). However, the infection can be reactivated if the host suffers some type
of immunosuppression (48).
In the third stage or progressive infection, the infection is not controlled by the
immune system and the virus replicates in the lymphoid tissue, in the bone marrow
and in the mucosal and glandular epithelial tissues. Cats that reach this state remain
viremic and positive throughout their lives, in addition to being a constant source of
infection (32). These animals develop diseases related to VLFecomo anemia,
lymphomas and secondary infections and usually die in a matter of years (35).

The fourth state or focal infection is characterized by a persistent atypical local viral
replication in the epithelial tissue of some organs, such as mammary glands, spleen,
bladder and eyes. Because this replication generates an intermittent production of
antigens, the tests can yield negative or positive results (39).
Among the clinical signs associated with the Feline Leukemia virus, we find
immunosuppression and development of hematological disorders, such as non-
regenerative anemia, aplastic anemia, lymphopenia, neutropenia, thrombocytopenia
and depletion of CD4 + and CD8 + lymphocytes. In the same way tumors,
neurological disorders, neuropathies, reproductive disorders and secondary
infections caused by opportunistic agents such as bacteria, fungi and protozoa may
occur (48) (50).
On the other hand, due to an abnormal response against the virus by the immune
system, immune-mediated diseases such as glomerulonephritis, uveitis and
polyarthritis can be generated. Especially, then infected neonates develop severe
atrophy of the thymus resulting in marked immunodeficiency and early death (35)
(51).
VLFese transmission occurs horizontally through contact with nasal gold secretions,
urine or contaminated stool. Also, through bites, daily activities such as playing,
mutual grooming and even sharing food and sand containers. Also vertically, from
mother to child during pregnancy or lactation (10) (11). Although its capacity for
infection is high, this virus does not have the capacity to survive for long periods of
time on dry surfaces in the environment, so its transmission through fomites is
unlikely (11).

The risk factors involved in the transmission of this disease are early age, intact
reproductive status, high animal density, low health conditions and free access to the
street (2) (48).
Several methods are used for the diagnosis of Feline Leukemia virus. Among the
main ones we found the ELISA test, which detects the p27 protein in the plasma and
infected cells and the immunochromatography tests also used for the diagnosis of
IVF (52). Among these tests we found the SNAP FIV / FeLV Combo Plus with 95%
sensitivity and 99% specificity (40) and the Anigen Rapid FIV / FeLV with 96.8% and
99.6% sensitivity and specificity respectively (41).
Among other diagnostic methods we find the direct immunofluorescence test (IFD),
PCR and virus isolation (11).
False negative results may occur in the early stages of the disease, because the
identification of the p27 protein is only possible after two weeks post infection, even
after three months. Similarly, false negatives may occur in IFD tests when there are
leukopenic states or in serology tests when they are performed during the lactating
infection phase (39) (53).

For this reason, tests with negative results from cats that were exposed to the virus
should be re-tested 30 days later or confirmed by PCR or virus isolation (39) (48).
The VLFe vaccine, although considered a non-essential vaccine by the World
Association of Small Animal Veterinarians (WSAVA), is recommended for animals
under 1 year old that have an outdoor lifestyle or that live with other cats that have
access to the street.
This vaccination should be done only in animals previously negativly diagnosed for
VLFe, by two doses given 2-4 weeks apart, starting after 8 weeks of age, with a
revaccination a year after the first dosication, and then revaccinations every three
years (43). It should be noted that there is still debate about the efficacy of this
vaccine, as well as its application to the development of sarcomas at the injection site
(54) (55).
The prevalence rates for the Feline Leukemia virus vary between countries. In
Canada and the United States, prevalences have been identified between 3.1% and
6.2% (1) (2) (12). In Europe, studies conducted in Germany, the United Kingdom and
Serbia have found prevalences of 3.6%, 3% and 1.3% respectively (5) (16) (56). In
Oceania, in countries such as New Zealand and Australia the prevalences were 1%
and 4% respectively (4) (46).

At Latin American level, three studies conducted in Brazil have identified prevalences
of 31% in the southern region of the country, 3% in the Northeast region and 4.5% in
the Midwest (8) (3) (14). In studies conducted in Mexico and Argentina, the
prevalences found were 7.5% and 7.69% respectively (18) (19). In Colombia, few
studies have addressed this problem, although in cities such as Bogotá, a study
carried out on clinically ill cats shows a prevalence of 13.1% (20). Similarly, in
Monteria, the prevalence for the Feline Leukemia virus was 23.3% (15).
Taking into account these characteristics, the general objective of this work was to
determine the prevalence of VLFe and FIV viruses in feline samples sent to the
veterinary laboratory EjeLab® Pereira, in order to estimate the current
epidemiological situation of both infections in our region.

Materials and methods

Geographic location
The veterinary laboratory EjeLab Pereira® is located in the urban area of the
municipality of Pereira, and currently receives samples from veterinary clinics located
in several places in the department of Risaralda, from both small and large species.

Type of study and selection of samples

A retrospective observational study was carried out, which included blood samples
from feline sent from the EjeLab Pereira® laboratory between April 2017 and April
2018, analyzed for VLFe and VIF, using the Kit Test Anigen Rapid FIV Ab / FeLV
Ag®, using whole blood, serum or plasma. This test has a sensitivity of 96.8% for VIF
and 94.7% for VLFe, and a Specificity of 99.6% for VIF and 99.7% for VLFe (41).
Sex, age and place of origin of the sample were recorded for each animal. These
data was obtained in the laboratory’s database with prior authorization. In addition,
socio-economic stratification maps were used to define the social state of the place
from where the sample was sent.
The cats were categorized into four age groups. Juvenile or Group 1 (<1 year), Adult
or Group 2 (1-6 years), Old or Group 3 (> 6 years) and Group 4 for which no ages
were reported.

Statistical analysis

The data was tabulated in Microsoft Excel® sheet and analyzed in the STATA14.0
program. Testing of association variables were performed using the chi square test.

Results
The population study included 308 cats, of which, 178 were males (57.7%) and 130
females (42.2%). The distribution by age was 78 juveniles (25.3%), 107 adults
(34.4%), 18 old (5.8%) and 105 whose ages were not reported (34.0%).
Of the total, 66 were positive for FIV (21.4%) and 75 for VLFe (24.3%), which
includes 28 cats that presented coinfection (9.1%) (Table 1). If the cases were
analyzed in monoinfection, for FIV there were 38 positive (12.3%) and for VLFe47
(15.3%).
Pereira was the municipality from which more samples of cats came for analysis, with
268 (87%), followed by Dosquebradas with 15 (4.8%) (Figure 1). Villavicencio and
Centro de Pereira city centers were the places where the largest number of samples
were sent, with 100 (32.4%) and 75 (24.3%) respectively (Figure 1). On the other
hand, remission was greater in stratum 5 with 117 samples (37.9%), followed by
stratum 4 with 102 (33.1%) and stratum 3 with 45 (14.6%).
According to the analyzes, the prevalence of FIV was higher in male cats (30.9%)
than in females (8.4%) (p <0.001) (Table 1), and it affected adult cats to a greater
extent (28, 9%) (p <0.001) (Table 2). On the other hand, of the cats whose stratum
was known, the prevalence was higher in those of stratum 3 (26.6%) (p <0.05).

Regarding VLFe, the results were very similar since the prevalence was higher in
males (28.6%) than in females (18.4%) (p <0.05) (Table 1), and also higher in adult
cats (28.9%) (p <0.05) (Table 2). Contrariwise, there were no significant differences
between strata.
Finally, coinfections were more prevalent in males (12.9%) than females (3.8%) (p
<0.01) (Table 1) and the prevalence was higher in the Cerritos commune of the city
of Pereira (28, 5%) (p <0.01).

Discussion

The Immunodeficiency and Feline Leukemia viruses continue to represent one of the
main causes of feline morbidity and mortality worldwide. This may be due to the ease
of transmission, the lack of prevention programs, as well as the low demographic
control and poor sanitation conditions, especially in developing countries.
The prevalence in this study for FIV was 21.4%, similar to that of studies conducted
in countries such as Argentina (21.45%), Japan (23%) and Australia (25%) ((17) (18)
( 45), although higher than those found in research in Canada (2.2%), Brazil (12.5%),
Mexico (2.5%) and Germany (3%) (2) (14) (16) ( 19).
Likewise, previously conducted studies in different regions of Colombia, using ELISA
tests as a diagnostic method, showed much lower prevalence than that reported in
the present study, varying between 1.6% and 11.4% (15) (20) (47).
According to the studies carried out, there was a significant difference between the
prevalences presented between males and females, which is consistent with the
findings found in other investigations (4) (7), since the former and especially the non-
castrated males, have more contact and fights with other cats, either for territory or
for reproduction, risking a greater extent of transmission of the virus through bites
(12).

Similarly, the data shown displays a higher prevalence in adult animals, similar to
that found in studies in Belgium, the United States and Canada (2) (57). This may be
due to the fact that, as mentioned above, adults are more likely to have aggressive
encounters with other cats, in addition to the vertical transmission of this virus is
unlikely (37).

On the other hand, there were no significant differences between the different places
where the samples came from in the case of both viruses, however, for FIV, the
positive animals sampled in clinics located in socioeconomic stratum 3 were
significantly higher than the others. This stratum is considered medium low,
therefore, the socioeconomic, health and control conditions on cats are lower, which
could explain this behavior.

One of the limitations of this study was the lack of information related to the lifestyle
of the cat, since it has been recognized as a risk factor for infection by FIV, frequent
access to the street (38), as evidenced in a study conducted in the United States, in
which the prevalence was higher in cats that did not have restricted access to it (58).
For this reason, it is necessary to conduct future investigations in Colombia that
relate this aspect to the presentation of VIF and VLFe. In addition to describing the
prevalence of these viruses between domestic and street cats, since previously
conducted studies have not evaluated these factors.

In the case of the immunodeficiency feline virus, the infected animals can survive for
almost the same time as a healthy animal, since the asymptomatic or latency phase
tends to last several years (13). However, during this stage of the infection, CD4 + /
CD8 + T lymphocytes continue to decrease, therefore, special care must be taken
into account, such as adequate nutrition, internal and external control of parasites, as
well as periodic monitoring, including weight control, hematological and biochemical
tests (39). For example, studies conducted in domestic animals in countries such as
Italy showed a mean life of infected cats of 5.6 years (9), another in Canada of 3.8
years (59) and in the United States of 4.9 years (58). According to the above, the
option to perform euthanasia based on a positive result should be reconsidered and
considered only in those cases in which the quality of life of the animal is affected.

Similarly, in order to avoid future infections, emphasis should be placed on the need
to separate infected cats from healthy ones, to prevent positive ones from having
access to the street and to sterilize them. As a preventive method, vaccination is
used in some countries such as the United States, Australia and Japan, which
consists of injecting inactivated virus, especially subtypes A and D (39). Based on the
fact that its effectiveness is still controversial, since it has had contradictory results in
different studies, the World Association of Small Animal Veterinarians (WSAVA) has
declared it a non-essential vaccine, and it is recommended only in cats with a high
risk of contract the disease (43).

Because this vaccine is not currently available in Latin America, veterinarians have
the task of preventing the spread of the virus educating of the owner, the
development of protection and prevention plans and awareness of the citizenship
about the seriousness of the infection by VIF.
The feline immunodeficiency virus has been used as a model for the study of the
infection of HIV in people, since in addition to being Lentivirus belonging to the
Retroviridae family, they have similarities in the structure of the genome and in
immunopathogenesis (37) (60 ).
The dynamics of infection of both viruses in their natural hosts are very similar, since
they can be transmitted by mucosal contact, blood transfusions and pre and post
natal routes (13).
On the other hand, the FIV and HIV genomes encode the same three main genes
found in all retroviruses, gag, pol and env; in addition to the genes of "viral infectivity
factor" (vif) and "virion expression regulator" (rev), although, they also encode
particular genes of each one (34).

In both cases, there are similarities in the presentation of the disease, starting with an
acute nonspecific phase, followed by an asymptomatic phase and finally a severe
immunosuppression stage that generates a susceptibility to opportunistic infectious
agents. Additionally, it is known that both infect CD4 + and CD8 + T lymphocytes, B
lymphocytes, monocytes, astrocytes and microglia cells (61) (62).
Bearing in mind these similarities, and apart from HIV, the feline immunodeficiency
virus is the only case of lentiviral infection causing immu- nospecificity in its natural
host (61), it is essential to continue research using FIV as a model for the analysis of
dynamics of infection and immunopathogenesis, as well as to evaluate vaccination
strategies in animal models in order to develop an effective immunization against HIV
and FIV.
In the present study, the prevalence for feline leukemia virus was 24.3%, one of the
highest in the world so far. Something similar was reported in Brazil, where a study
conducted in the southern region of the country showed a prevalence of 31% (8).
Unlike this, the prevalences found in countries such as the United States (5.3%) (1),
Canada (6.2%) (12), Germany (3.6%) (16), United Kingdom (3%) (5), Australia (4%)
(46) and Argentina (7.69%) (18) were much smaller.
In Colombia, two previous investigations have been carried out, one in the city of
Bogotá where a prevalence of 13.1% (20) was found and another in Monteria with a
result of 23.3% (15), similar to that reported in the present work.
On the other hand, according to the results, the infection by VLFe was higher in
males than in females, similar to that found in previous studies (2) (7) (63). Although
VLFe infection is not as strongly associated with the aggressive and territorial
behavior of males as in the case of FIV (8), sex still represents a risk factor, since
transmission of the virus can occur through of nasal gold secretions and bites (48).
Similarly, the prevalence of VLFe was higher in adult animals, which differs from
studies that report higher rates of positivity in young cats. According to these,
puppies have an immature immune system, which predisposes them to an early
trans-placental and trans-mammary infection (58) (63) (64). In addition, survival has
been associated from 2 to 3 years after infection, causing many cats not to reach late
adulthood, since it is a very pathogenic and aggressive virus (9) (38).
However, research in Australia and Germany showed higher prevalences in adult
cats, suggesting a change in VLFe infection, where older animals would be more
predisposed to become infected (16) (46).

Although it has been reported that prevalence rates of VLFe have decreased during
the last years (49), the results obtained in this research show the opposite, and as in
the case of VIF, future research is needed in Latin America, specially in Colombia, to
analyze and relate VLFe infection with aspects such as cat’s lifestyle, sex, age and
race, in order to obtain information to help the control and prevention of this disease.
The management of feline leukemia is difficult, due to the ease of transmission, the
manifestation of the disease during its different stages and the ability of cats with
lactating infection to become viremic. 10% of infected cats become dormant, do not
transmit VLFe and viremia is undetectable, however, the animal can become viremic
and expel the virus again by secretions (48) (54).

On the other hand, 40% of cats exposed to the virus develop what is known as
progressive infection, where they remain viremic and positive throughout their lives,
in addition to being a constant source of infection (32). Finally, 50% of the cats
remain in the abortive infection phase, where the immune system manages to control
the infection, the cats do not become viremic and are not considered as a source of
transmission of the disease (54).
Taking into account the above, the risk of transmission of the virus is considerably
high, so special considerations should be taken with those positive cats, such as
separating them from the uninfected, sterilizing and controlling the street habit.
Likewise, it is recommended that animals suffering from the feline leukemia virus visit
the veterinarian regularly to perform blood tests, blood chemistries and uroanalysis,
in order to control the disease (13).
The life expectancy of infection by VLFees is lower compared to VIF, since in
addition to being a much more pathogenic virus, it is the cause of more clinical
syndromes than any other agent in cats, because it causes a greater
immunosuppression of the host, causing a rapid development of diseases related to
VLFe, and consequently, death (9) (35).
Previous studies have reported significant differences between the average time of
life of infected and uninfected cats. For example, in Germany, the survival of positive
cats was 311.9 days (16). Another in Switzerland reported a life average of 3.1 years
(65). However, in an investigation conducted in Italy, some cats lived up to 8.5 years
(9).

Considering this, the infection by VLFe should not be appreciated as a death


sentence, the same with the feline immunodeficiency virus, the option of performing
euthanasia based on a positive result should be reconsidered, and considered only in
those cases in which the quality of life of the animal is affected. Likewise, to prevent
the rapid development of the disease, special care is necessary, such as a
nutritionally balanced diet, an adequate environment, control of external and internal
parasites, weight control, and periodic visits to the veterinarian (39).
Vaccination against the Leukemia Feline virus, despite not being considered
essential, is recommended in all cats under 1 year of age and in those who have a
high risk of exposure to the virus due to their lifestyle (66). Although vaccines do not
grant 100% protection, they can be a determining factor in terms of prevention. In
addition, adequate immunization of cats can reduce the incidence by 70% (13). It
should be noted that there is still debate about the efficacy of this vaccine, as well as
its application to the development of sarcomas at the injection site (54) (55).

Despite having this tool, early detection and adequate separation of infected cats
remains essential, limiting and reducing the transmission of the virus. Veterinarians
have the task of raising awareness and educating the owner, seeking to reduce the
impact of this disease on the feline population.
Finally, the percentage of coinfections in the present study was 9.1%, with a
significantly higher prevalence in males, possibly due to their aggressive and
territorial attitude. Other studies have reported prevalences of 2.6% in Malaysia, 2%
in Australia and 2.7% in Bogotá, Colombia (7) (20) (46). Although there are different
opinions about the interactions of FIV and VLFe, it is believed that coinfection with
both viruses leads to greater morbidity and mortality than when a single infection
manifests (7) (9). Likewise, coinfections of FIV and VLFe have been reported with
Leishmania chagasi, Toxoplasma gondii and Mycoplasma spp (67) (68). According to
the above, studies are necessary to analyze and relate the presentation of two or
more diseases with the severity and development of infectious diseases, taking into
account, in addition, risk factors such as sex, age and life style.

Conclusions and recommendations

The prevalences of immunodeficiency and feline leukemia found in this work are
among the highest reported so far worldwide. Taking into account that they are two of
the diseases that have higher rates of morbidity and mortality in cats, it is necessary
to generate a greater knowledge about the epidemiological dynamics of both viruses,
mainly in Latin America. Future research should be aimed not only at identifying risk
factors for infection, but also aimed at the genotypic study of FIV and VLFe and their
interactions in cases of coinfection, in order to understand the processes of
transmission, clinical presentation and repercussions on animal health.
Male genre and adulthood were identified as risk factors for infection by both viruses,
consistent with the findings of other studies. According to this, efforts to prevent
dissemination should be made in programs of protection and prevention, either
education about the risks of street habits, or through population and behavioral
control through sterilization. Likewise, the lifestyle and the environment in which the
infected animal lives should be the subject of study of future research, especially in
Colombia.
Although the effectiveness and convenience of vaccines is still a matter of debate,
they are tools that could help control these diseases. Therefore, the veterinarian
should recommend them within the existing immunization plans, taking into account
that in Colombia there is only availability of the VLFe vaccine.

Finally, thanks to the similarities between HIV and FIV, the immunodeficiency feline
virus is presented as an optimal model for the study and understanding of the
immunopathology of both retro-viruses, which is encouraging in the search for a cure
or an eventual vaccine against the human immunodeficiency virus.