Pre- and postexposure chemoprophylaxis: evidence that 3'-azido-3'-dideoxythymidine inhibits feline leukemia virus disease by a drug-induced vaccine response.

The benefits of postexposure 3'-azido-3'-dideoxythymidine (AZT) prophylaxis following human immunodeficiency virus exposure are unknown. We describe a comprehensive assessment of pre- and postexposure AZT therapy in the feline leukemia virus (FeLV)-cat model for AIDS which included in vitro testing, an in vivo dose-response titration, a postexposure treatment study, plasma drug concentration determinations, and evaluation of the immune response to FeLV. In in vitro studies, AZT prevented FeLV infection of a feline T-lymphoid cell line, giving 50 and 90% inhibition concentrations of 4.6 and 11.1 mM, respectively. In all of the in vivo efficacy studies, AZT was administered by continuous subcutaneous infusion for 28 days. AZT toxicity was excessive at a dosage of 120 mg/kg of body weight per day, causing acute anemia, but AZT was tolerable at 60 mg/kg/day. In preexposure studies, AZT was efficacious in preventing chronic antigenemia at a dosage of > or = 15 mg/kg/day, at which plasma AZT concentrations averaged between 0.51 and 0.81 micrograms/ml (2.13 and 3.03 microM). As a postexposure treatment, at 60 mg/kg/day, AZT prevented chronic FeLV antigenemia when treatment was started up to 96 h post-virus inoculation (p.i.), but not when treatment was started at 192 h p.i. The 4-day period between 96 and 192 h p.i. appears to be critical for establishing chronic viremia. It is presumed that the increase in virus load between 4 and 8 days p.i. was able to overwhelm the immunologic functions responsible for containment of FeLV infection, even though AZT therapy effectively controlled viremia during the treatment period. The antibody response to FeLV varied depending on the time of AZT treatment initiation relative to virus challenge. When AZT treatment was started 48 h before or 8 h after FeLV challenge, antibodies to FeLV were not detected until after AZT treatment was discontinued at 28 days p.i. Following AZT treatment, however, antibody titers rapidly increased at a rate suggestive of a secondary immune response. When AZT treatment was initiate at later time points relative to virus challenge (24, 48, and 96 h p.i.), antibodies to FeLV became detectable during the treatment period. These results indicate that AZT treatment does not completely prevent FeLV infection, even when treatment begins before virus challenge, and that immune sensitization to FeLV proceeds during the prophylactic drug treatment period.

Prophylactic and therapeutic effects of phosphonoformate against feline leukemia virus in vitro.

Phosphonoformate (PFA), a noncompetitive inhibitor of reverse transcriptase (RT), inhibited feline leukemia virus (FeLV) infection of 2 feline cell lines and inhibited progeny virus RT activity in a chronically FeLV-infected cell line. Feline leukemia virus infection of 3201 cells, an FeLV-negative lymphoma cell line, was inhibited by greater than 70% at a concentration of only 1 microM PFA and by greater than 90% at concentrations of 64 to 256 microM PFA, as evidenced by RT activity. However, FeLV antigen expression by 3201 cells remained relatively constant over noncytotoxic concentrations of PFA. Because the persistence of viral antigen expression with concomitant suppression of RT activity appears to be unique and because 3201 cells express small amounts of an endogenous retrovirus (RD-114) and contain endogenous FeLV proviral sequences, a possible role of endogenous retroviruses acting as helper viruses was suggested. Feline leukemia virus infection of 81C cells, a sarcoma-positive, leukemia-negative fibroblast cell line, was inhibited by greater than 50% at a concentration of 64 microM PFA and by greater than 98% at concentrations of 256 to 512 microM PFA, as indicated by suppression of focus formation. The feline lymphoid cell line FL-74 is a large producer of FeLV. When FL-74 cells were cultured in the presence of 256 microM PFA, virus production (virus budding and viral antigen) was not affected, but progeny virus lost RT activity and infectivity. Direct addition of PFA (256 microM) to FeLV also reduced RT activity and infectivity. These data indicate that PFA can directly and rapidly inactivate retrovirus independent of cellular processing, presumably by inhibiting RT.(ABSTRACT TRUNCATED AT 250 WORDS)

Evaluation of antiviral activity and toxicity of dextran sulfate in feline leukemia virus-infected cats.

The feline leukemia virus (FeLV) disease model was used to conduct a toxicity and antiretrovirus efficacy trial of dextran sulfate (DS; molecular mass, 7,000 to 8,000 Da). In vitro, FeLV infection of feline lymphoid cells was inhibited by 10 micrograms of DS per ml. DS was administered to cats by continuous intravenous infusion at doses of 600, 120, 24, or 4.8 mg/kg of body weight per day, beginning 24 h before FeLV challenge. Doses of 24 mg/kg/day and more were excessively toxic, causing intestinal lesions and death. Similar changes were observed in unchallenged animals receiving 24 mg/kg/day, indicating that toxicity was DS mediated. The dosage of 4.8 mg/kg/day was subtoxic but did not prevent the induction and persistence of FeLV viremia. The results demonstrate that DS by continuous intravenous infusion is excessively toxic at high doses and ineffective at preventing FeLV infection at a subtoxic dose in the FeLV cat model.

In vitro and in vivo evidence that the antiviral activity of 2',3'-dideoxycytidine is target cell dependent in a feline retrovirus animal model.

2',3'-Dideoxycytidine (DDC) was evaluated for prophylactic antiviral activity in vitro and in vivo, using the feline leukemia virus (FeLV)-cat animal model. In vitro antiviral activity of DDC against FeLV was dependent upon the target cell used for infection. DDC (5 to 10 microM) inhibited FeLV infection of feline lymphoid cells by greater than 80%, while 6.07 to 12.13 microM DDC was required to similarly inhibit infection of feline fibroblasts. However, 43 to 384 microM DDC was needed to inhibit FeLV infection of primary bone marrow cells by greater than 80%. These in vitro results suggest that, although relatively low doses of DDC may be adequate to prevent infection of feline lymphoid cells, 8- to 80-times-higher doses may be necessary to block infection of bone marrow cells, a primary target cell type for FeLV infection. In vivo studies with DDC consisted of pharmacokinetic and toxicity determinations and evaluation of the prophylactic antiviral activity against FeLV in cats. Clearance and half-life values for DDC in cats were 6.5 ml/min per kg and 54.7 min, respectively. In the prophylactic studies, DDC was administered by continuous intravenous infusion at doses of 22, 15, 10, and 5 mg/kg per h for 28 days in most animals. Cats were challenged intravenously with FeLV 1 to 3 days after drug treatment began. Doses of 22 and 15 mg/kg per h were extremely toxic, causing death in 8 of 10 cats. The mg/kg per h dose was slightly toxic, causing chronic progressive thrombocytopenia over the 28-day treatment period. Of 10 cats given 10 to 5 mg of DDC per kg per h, only one was completely protected from FeLV antigenemia. However, conversion to positive FeLV antigenemia status was delayed by 2 to 7 weeks in seven of nine remaining animals. Interestingly, FeLV infection of bone marrow cells, as indicated by FELV antigen in peripheral blood neutrophils, was only slightly delayed by 0 to 2 weeks, except in the case of the one protected cat, and usually preceded conversion to antigenemia. This pattern of neutrophils becoming antigen positive before detection of antigenemia was not seen in FeLV challenge control animals and indicates that the antiviral activity of DDC may be incomplete during DDC treatment. Results of our in vitro and in vivo studies suggest that feline bone marrow cells may remain partially susceptible to FeLV infection at tolerated doses, while other somatic target tissues (i.e., lymphoid or epithelial tissues) may be protected from infection. Incomplete inhibition of FeLV infection permitted focal bone marrow infection to develop in cats given DDC. These loci of infection served as virus reservoirs which, subsequent to discontinuation of DDC treatment, permitted spread of infection to tissues previously protected during treatment.

Age-related differences in pharmacokinetics of phosphonoformate in cats.

Phosphonoformate (PFA) is a simple PPi analog which inhibits the activities of a variety of viral DNA polymerase, RNA polymerase, and reverse transcriptase enzymes. PFA is a topical and parenteral treatment for human herpesvirus infections and is currently in phase I trials for treatment of acquired immunodeficiency syndrome. Pharmacokinetic properties of PFA in young (growing) and adult specific-pathogen-free cats were compared. Mean PFA clearance from plasma was twofold higher in young cats (7.52 ml/min per kg of body weight) than in adult cats (3.70 ml/min per kg). Higher PFA clearance from plasma observed in young cats may result from higher renal clearance or enhanced accumulation of PFA in bone tissue of young versus adult cats. No plasma protein binding of PFA was observed. Mean oral bioavailability was 35% in young cats. These data indicate that age-related differences in PFA clearance from plasma occur in cats.