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Plerixafor in the treatment of FIV-positive cats
Bicyclam derivatives inhibit feline immunodeficiency virus (FIV) replication through selective blockage of chemokine receptor CXCR4.
Is the CXCR4 antagonist plerixafor (AMD3100, 1,1′-bis-1,4,8,11-tetraazacyclotetradekan) alone or in combination with adefovir (PMEA, 9-(2-phosphonylmethoxyethyl)adenine) safe and effective for treating FIV-infected cats?


Forty naturally FIV-infected, privately owned cats were included in this prospective, placebo-controlled, double-blind clinical trial.

Cats were randomly classified into 4 treatment groups. Received AMD3100, PMEA, AMD3100 in combination with PMEA, or placebo for 6 weeks. Clinical and laboratory parameters, including CD4+ and CD8+ cell counts, FIV proviral and viral load measured by quantitative polymerase chain reaction (qPCR) evaluated.
Additionally, FIV isolates from cats treated with AMD3100 tested for drug resistance.

Results: FIV-infected cats treated with AMD3100 caused significant decrease in proviral load compared to placebo group (2.3 ± 3.8% to 1.9 ± 3.1%, of blood lymphocytes P < .05), but did not lead to improvement of clinical or immunological variables; it caused a decrease in serum magnesium concentration without clinical signs.

No development of resistance of FIV isolates to AMD3100 found during treatment period. PMEA administration improved stomatitis (stomatitis score [degree 1 – 100] PMEA group: 23 ± 19 to 11 ± 10, P < .001; AMD3100 + PMEA group: 12 ± 17 to 3 ± 5, P < .05), but did not decrease proviral or viral load and caused anemia (RBC [×106/μL] PMEA group: 9.07 ± 1.60 to 6.22 ± 2.16, P < .05; AMD3100 ± PMEA group: 8.80 ± 1.23 to 5.84 ± 1.58, P < .001).

Conclusions and Clinical Importance: Administration of CXCR4 antagonists, as AMD3100, can induce reduction of proviral load and may represent viable treatment of FIV-infected cats. Combination treatment with PMEA not recommended.


Source: Hartmann, K., Stengel, C., Klein, D., Egberink, H. and Balzarini, J. (2012), Efficacy and Adverse Effects of the Antiviral Compound Plerixafor in Feline Immunodeficiency Virus-Infected Cats. Journal of Veterinary Internal Medicine, 26: 483–490. doi: 10.1111/j.1939-1676.2012.00904.x




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