Virbac Sa · EURONEXT:VIRP
Virbac Sa — Technical Presentation (2019)
49 slides from Virbac Sa's technical presentation, 2019
Slide 1: Dr Mark Westman, University of Sydney
Dr Mark Westman, University of Sydney FACULTY OF VETERINARY SCIENCE 1
Slide 2: Outline of webinar
Outline of webinar What we will cover: 1. FIV and FeLV infection – Pathogenesis 2. FIV and FeLV infection – Disease associations 3. FIV and FeLV prevalence – Australia and NZ 4. FIV and FeLV infection – Diagnostic challenges 5. FIV and FeLV vaccination Image courtesy of Lynda du Cross 2
Slide 3: My background
My background 2003 Image courtesy of Linda Warlond, Clique Photography 3
Slide 4: 1. Retroviruses – A review of pathogenesis
1. Retroviruses – A review of pathogenesis Provirus Host genome Integrase RNA cDNA Reverse transcriptase Retrovirus image courtesy of Prof Brian Willett A retrovirus 4
Slide 5: 1. FIV pathogenesis
1. FIV pathogenesis Hosie and Beatty 20071 Image courtesy of Lynda du Cross 5
Slide 6: 1. FeLV pathogenesis
1. FeLV pathogenesis a) Abortive infection FeLV b) Progressive infection c) Regressive infection Image courtesy of Lynda du Cross 6
Slide 7: 1. FeLV pathogenesis: abortive infection
1. FeLV pathogenesis a) Outcome of FeLV exposure: ABORTIVE infection FeLV Antigen (p27) PCR Image courtesy of Prof Vanessa Barrs 7
Slide 8: 1. FeLV pathogenesis: progressive infection
1. FeLV pathogenesis b) Outcome of FeLV exposure: PROGRESSIVE infection Spleen Kidneys GIT etc. FeLV BM Antigen (p27) PCR Image courtesy of Prof Vanessa Barrs 8
Slide 9: 1. FeLV pathogenesis: regressive infection
1. FeLV pathogenesis c) Outcome of FeLV exposure: REGRESSIVE infection 2-14 wks FeLV BM Antigen (p27) PCR then Image courtesy of Prof Vanessa Barrs 9
Slide 10: 2. FIV disease associations
2. FIV disease associations 1/17 cats in Group 1 (Chicago) died from hypertrophic cardiomyopathy 17/27 cats in Group 2 (Memphis) died, of which 9 died from lymphoma and 13 had some evidence of lymphoid disease (lymphoma, lymphoid hyperplasia or lymphoid depletion) “Therefore, it appears that FIV inf
Slide 11: 2. FIV disease associations
2. FIV disease associations six times more likely USA study - FIV-infected cats were to develop leukaemia or lymphoma than FIV-uninfected cats3 11
Slide 12: 2. FeLV disease associations (progressive)
2. FeLV disease associations (progressive) Brazil - 57% (30/53) of lymphomas from FeLV-positive cats4 USA study - FeLV-infected cats 62 times more likely to develop leukaemia or lymphoma than FeLV-uninfected cats3 Cristo et al. 20192 12
Slide 13: 2. FeLV disease associations (progressive)
2. FeLV disease associations (progressive) “…most will develop disease. Of these, 70 – 90% will have died within 18 months – 3 years” BUT “Some may remain healthy for many years before one of the FeLV-related diseases develops, and occasional cases remain permanently healthy”5 Images courtesy of Lyn
Slide 14: 2. Re-homing progressively FeLV-infected cats
2. Re-homing progressively FeLV-infected cats https://www.austinpetsalive.org/about/programs/felv-adoption/ 14
Slide 15: 2. FeLV disease associations (regressive)
2. FeLV disease associations (regressive) McLuckie et al. (2018) – 42 cases of lymphoma in cats with formalin-fixed, paraffin embedded tissue available, as well as FeLV/FIV PoC testing and FeLV PCR testing (note figure shows results for 59 cats)6 - 11/42 (26%) cats diagnosed with regressive FeLV inf
Slide 16: 3. FIV and FeLV prevalence - Australia
3. FIV and FeLV prevalence - Australia Westman et al. 20167 FIV Progressive FeLV 305/2,083 (15%) in 2011-137 32/2,032 (2%) in 2011-137 16
Slide 17: 3. FIV and FeLV prevalence – NZ
3. FIV and FeLV prevalence – NZ FIV Progressive FeLV 20/200 (10%) – published 20138 11/200 (5.5%) – published 20138 17
Slide 18: 3. Regressive FeLV prevalence
3. Regressive FeLV prevalence Country FeLV-infected Progressive infections Regressive infections Switzerland9 41/597 (7%) 61/597 (10%) Switzerland10 54/445 (12%) 24/445 (5%) UK11 56/465 (12%) 45/465 (10%) Australia12 2/248 (1%) 3/248 (1%) Germany13 9/495 (2%) 6/495 (1%) 18
Slide 19: 4. FIV/FeLV – A review of diagnosis
4. FIV/FeLV – A review of diagnosis Provirus Host genome Integrase RNA cDNA Reverse transcriptase FeLV +ve FeLV/FIV 1. Antigen testing (FeLV) 19
Slide 20: 4. FIV/FeLV – A review of diagnosis
4. FIV/FeLV – A review of diagnosis Provirus Host genome Integrase RNA cDNA Reverse transcriptase FeLV +ve FIV +ve FeLV/FIV 1. Antigen testing (FeLV) 2. Antibody testing (FIV) 20
Slide 21: 4. FIV/FeLV – A review of diagnosis
4. FIV/FeLV – A review of diagnosis 3. PCR testing (FIV and FeLV) Provirus Host genome Integrase RNA cDNA Reverse transcriptase FeLV +ve FIV +ve FeLV/FIV 1. Antigen (Ag) testing (FeLV) 2. Antibody (Ab) testing (FIV) 21
Slide 22: 4. Challenges with diagnosis – FIV infection
4. Challenges with diagnosis – FIV infection Test Target Abs Can differentiate FIV- vaccinated and FIV-infected?14 SNAP Combo® p15, p24 +/- gp40 Witness® gp40 Anigen Rapid® gp40 22 22
Slide 23: FIV testing – Take home message #1
FIV testing – Take home message #1 In areas where FIV vaccination is practiced (currently Australia, New Zealand and Japan), and particularly in shelters where FIV vaccination history is often unknown, screening for FIV infection should be performed using Witness® or Anigen Rapid® FIV test kits14,15
Slide 24: 4. Challenges with diagnosis – FIV infection
4. Challenges with diagnosis – FIV infection FIV antibody-testing (with Witness and Anigen Rapid) is more reliable than PCR testing 2/5 FIV-vaccinated/FIV-infected cats required multiple IDEXX FIV RealPCRTM testing to get a positive result (i.e. some false-negative PCR results) PCR testing Hosie and
Slide 25: 4. Challenges with diagnosis – FIV infection
4. Challenges with diagnosis – FIV infection Encourage companies to invest in independent research by asking questions and thinking critically! 25
Slide 26: 4. FeLV diagnosis
4. FeLV diagnosis Outcomes of FeLV exposure: 1. Abortive infection 2. Progressive infection 3. Regressive infection Antigen (p27) PCR 1. Abortive (20-30%) 2. Progressive (30-40%) 3. Regressive (30-40%) then 26
Slide 27: 4. Challenges with diagnosis - progressive FeLV
4. Challenges with diagnosis - progressive FeLV IDEXX Laboratories, SNAP FIV/FeLV Combo® Sensitivity (progressive FeLV) 98.6% Specificity (progressive FeLV) 98.2%17 *** What is the positive predictive value? (PPV) *** 27
Slide 28: 4. Challenges with diagnosis - progressive FeLV
4. Challenges with diagnosis - progressive FeLV https://uwsheltermedicine.com/library/resources/positive-and-negative-predictive-value-calculator-for-diagnostic-testing 28
Slide 29: 4. Challenges with diagnosis - progressive FeLV
4. Challenges with diagnosis - progressive FeLV https://uwsheltermedicine.com/library/resources/positive-and-negative-predictive-value-calculator-for-diagnostic-testing 29
Slide 30: FeLV testing – Take home message #2
FeLV testing – Take home message #2 A positive FeLV result with rapid (point-of-care) testing should ALWAYS be followed by PCR testing5 ‘Randy’ No FeLV PCR? Skittles 30
Slide 31: FeLV testing: examples of false-positives
FeLV testing: examples of false-positives Sick animal – ‘Marcus’ Sick animal (2 different kits) – ‘Skittles’ Healthy animal – ‘Claudia’ Sick animal after blood transfusion – ‘Ranger’ FALSE +VE With thanks to Drs Marshall Thornton, Christine Cole and Katherine Briscoe for the images 31
Slide 32: FeLV testing: examples of false-positives
FeLV testing: examples of false-positives Progressive FeLV 11/200 (5.5%) cats from this study were FeLV antigen positive8 None of these 11 samples were FeLV PCR positive (unpublished) 32
Slide 33: 4. Challenges with diagnosis - regressive FeLV
4. Challenges with diagnosis - regressive FeLV Outcomes of FeLV exposure: REGRESSIVE infection 2-14 wks FeLV BM Antigen (p27) PCR then Image courtesy of Prof Vanessa Barrs 33
Slide 34: 4. Challenges with diagnosis - regressive FeLV
4. Challenges with diagnosis - regressive FeLV --------------------------- --------------------------- Weeks Weeks A B No significant difference was found in the very early phase of the infection between cats that subsequently became progressively FeLV infected and cats that became regressively FeLV
Slide 35: FeLV testing – Take home message #3
FeLV testing – Take home message #3 A positive FeLV result with rapid (point-of-care) testing should ALWAYS be followed by PCR testing5 ‘Randy’ No FeLV PCR? Skittles And if both are positive, FeLV point-of-care testing should be repeated 3-4 months later5 35
Slide 36: 4. Challenges with diagnosis - regressive FeLV
4. Challenges with diagnosis - regressive FeLV 10 uninfected cats transfused with blood from regressively FeLV infected cats (Ag-, PCR+) 2/10 of the transfused cats developed progressive FeLV infection, 6/10 developed regressive FeLV infection19 Image courtesy of Dr Duana Mc Bride 36
Slide 37: FeLV testing – Take home message #4
FeLV testing – Take home message #4 Image courtesy of Dr Duana Mc Bride FeLV Ag and PCR testing of all blood donor cats should be performed!20 37
Slide 38: 4. Challenges with FIV and FeLV diagnosis
4. Challenges with FIV and FeLV diagnosis https://uwsheltermedicine.com/library/resources/why-are-some-shelters-no-longer-testing-all-cats-for-felv-and-fiv 38
Slide 39: 5. FIV and FeLV vaccination
5. FIV and FeLV vaccination Q - To vaccinate or not to vaccinate? 39
Slide 40: 5. FIV and FeLV vaccination
5. FIV and FeLV vaccination WSAVA Vaccination Guidelines 201521 Both FIV & FeLV vaccination are considered ‘non-core’ (AKA optional) 40
Slide 41: 5. FIV and FeLV vaccination
5. FIV and FeLV vaccination Things to consider: - Individual risk factors for the cat - Local prevalence - Safety of the vaccine - Vaccine effectiveness • FIV vaccine – 56% (Australian field study)22 • Jarrett and Ganiere (1996) – combined efficacy for Leucogen was 63%23 41
Slide 42: 5. FIV and FeLV vaccination
5. FIV and FeLV vaccination Things to consider: - Recommend FIV/FeLV testing prior to annual vaccination using a rapid (point-of-care) test kit to look for ‘vaccine breakthroughs’ 42
Slide 43: Further reading
Further reading Westman M, Malik R, Norris J. Diagnosing feline immunodeficiency virus (FIV) and feline leukaemia virus (FeLV) infection: an update for clinicians. Aust Vet J. 2019; 97(3): 47-55. 43
Slide 44: Acknowledgements
RD SYDNEY Acknowledgements V2 THE UNIVERSITY OF Boehringer SYDNEY {i Ingelheim Ine i a zoetis i es J/AW/A AUSTRALIAN ee > SMALL ANIMAL a pata zx AUSTRALIAN VETERINARY VETERINARIANS a iK\ ASSOCIATION @.. Australia Awards Scholarships secratan eas ENDEAVOUR ae ‘alian Compa * Animal Scholarships and Fe
Slide 45: Acknowledgements
Acknowledgements www.petsinthepark.org.au 45
Slide 46: References (1)
References (1) 1. Hosie, M.J., Beatty, J.A., 2007. Vaccine protection against feline immunodeficiency virus: setting the challenge. Aust. Vet. J. 85, 5-12. 2. Bęczkowski PM, Litster A, Lin TL, Mellor DJ, Willett BJ, Hosie MJ. Contrasting clinical outcomes in two cohorts of cats naturally infected wi
Slide 47: References (2)
References (2) 15. Crawford C. Does a DIVA test exist for differentiating FIV infection from FIV vaccination? (2016 ACVIM Forum Research Abstract Program). J Vet Intern Med. 2016;30(4):1475. 16. Westman ME, Malik R, Hall E, Harris M, Hosie MJ, Sheehy PA, et al. Duration of antibody response followin
Slide 48: Quiz! Questions:
Quiz! Questions: 1. According to the Jenkins et al. study published in 2013, what is the prevalence of FIV infection in New Zealand? 2. According to the Jenkins et al. study published in 2013, what is the prevalence of progressive FeLV infection in New Zealand? 3. Witness and Anigen Rapid FIV test k
Slide 49: Thank you for listening!
Thank you for listening! [email protected] 49