Prevalence and risk factors for cats testing positive for feline immunodeficiency virus and feline leukaemia virus infection in cats entering an animal shelter in New Zealand

Study of feline immunodeficiency virus prevalence and expert opinions on standards of care

OBJECTIVE

The purpose of this study was to identify knowledge gaps in the global prevalence of feline immunodeficiency virus (FIV) and to obtain professional opinions and experiences regarding FIV in selected countries. We conducted a literature review of abstracts that reported the prevalence of FIV and interviewed experts in feline medicine and retroviruses from different countries to determine regional perspectives.

METHODS

A total of 90 articles reporting FIV prevalence as a primary unbiased population-level analysis between 1980 and 2017 were indexed. FIV prevalence, demographics, year and location were analyzed. Statistics were evaluated and compared. In total, 10 experts were interviewed. Results were analyzed for congruence with the findings of the literature review.

RESULTS

FIV prevalence was typically in the range of 5-8%, with a global prevalence of 4.7%, and remained largely constant over the reporting period (1980-2017). Over 90% of articles reported greater prevalence in older male cats. More studies were conducted in North America and Europe and reported the lowest prevalence. Expert-estimated prevalence approximated literature review prevalence. Attitudes and recommendations for management were consistent among experts. The limitations of the present review include varying inclusion criteria of cats tested in different studies, variation in testing modalities and the inability to conduct summary statistics across dissimilar cohorts.

CONCLUSIONS AND RELEVANCE

The global prevalence of FIV has not changed since its discovery 40 years ago. Prevalence is higher in older male cats and is lower in North America and Europe than other continents. Experts agree that FIV is not typically a disease of high concern and is often associated with infections of the oral cavity. Vaccination is not typically recommended and has been discontinued in North America. The evaluation of risk factors for FIV progression is useful in managing infections. Recommendations for future research include analyses to determine copathogen and environmental factors that impact progression, assessment of life span impacts and investigations of treatment efficacy and side effects.

Performance and overview of clinically relevant areas of application of saliva testing in the cat

Introduction

The cat represents an important model in order to investigate basic physiological knowledge of salivary secretion as well as pharmacokinetics of active substances.

Objective

The aim of the study was to review in which diagnostic application areas saliva testing is routinely used and in which areas it could be further explored in the future.

Materials and methods

Literature relevant to the research question was collected in March 2022 using the Pubmed database.

Results

The diagnosis of infectious diseases in cat saliva is one of the most important fields of application. Saliva diagnostics may also indicate dental diseases, allergies or kidney and other metabolic diseases. Sexual and stress hormones can also be measured in cat saliva. A number of clinically relevant allergens in cat saliva that may cause allergies in humans has been investigated and described, in addition to infectious agents that can be transmitted from cats to humans.

Conclusions

Saliva testing in cats can be useful in many areas, including the detection of infectious diseases, allergies and dental disease. However, it is far from being used to its full potential within veterinary medicine.

Prospective Investigation of Feline Leukemia Virus Infection in Stray Cats Subjected to a Trap-Neuter-Return Program in Switzerland

Feline leukemia virus (FeLV) remains a serious concern in some countries despite advances in diagnostics and vaccines. FeLV-infected cats often have reduced lifespans due to FeLV-associated diseases. The infection is transmitted through social interactions. While Northern European countries have reported a decrease in FeLV among pet cats, Switzerland's rates remain stagnant at 2.7% (2016/17: 95% CI 1.4-5.2%). Research on FeLV in Swiss stray cats has been lacking, even though these animals could serve as a virus reservoir. Sampling stray cats that do not receive regular veterinary care can be challenging. Collaboration with the Swiss Network for Animal Protection (NetAP) allowed for the prospective collection of saliva samples from 1711 stray cats during a trap-neuter-return program from 2019 to 2023. These samples were tested for FeLV RNA using RT-qPCR as a measure for antigenemia. Viral RNA was detected in 4.0% (95% CI 3.1-5.0%) of the samples, with 7.7% (95% CI 4.9-11.3%) in sick cats and 3.3% (95% CI 2.4-4.4%) in healthy ones. We identified three geographically independent hotspots with alarmingly high FeLV infection rates in stray cats (up to 70%). Overall, including the previous data of privately owned cats, FeLV-positive cats were scattered throughout Switzerland in 24/26 cantons. Our findings underscore welfare concerns for FeLV infections among stray cats lacking veterinary attention, highlighting the potential risk of infection to other free-roaming cats, including those privately owned. This emphasizes the critical significance of vaccinating all cats with outdoor access against FeLV and developing programs to protect cats from FeLV infections.

Detection of feline immunodeficiency virus by neutral red-based loop-mediated isothermal amplification assay

Background and Aim

Feline immunodeficiency virus (FIV) is a retroviral pathogen globally responsible for immunodeficiency disease in cats. However, the current diagnosis based on antibody detection has limitations and can also produce false-positive results. This study aimed to develop a one-pot loop-mediated isothermal amplification (LAMP) process integrated with neutral red (NR-LAMP) assay for detection of FIV proviral DNA.

Materials and Methods

We developed a one-pot, gag gene-based NR-LAMP for convenient, rapid, specific, and sensitive colorimetric inspection of FIV proviral DNA.

Results

The developed NR-LAMP was capable of amplifying at an optimum temperature of 65°C for 40 min. No cross-amplification was detected between FIV and other feline viruses tested, indicating the high specificity (98.44%) of the novel FIV-LAMP primer. Our NR-LAMP assay has a detection limit of 4.2 × 101 copies/μL. A total of 80 clinical samples with a background of FIV infection were collected and tested using the proposed method. The NR-LAMP assay showed a high sensitivity of 100% compared to conventional polymerase chain reaction assay.

Conclusion

These results support the suitability of NR-LAMP as a potential future alternative clinical molecular approach for further use in the diagnosis of FIV-infected cats.

Feral Cat Populations and Feline Retrovirus Prevalence in San Mateo County, California in Three Time Periods between 2001 and 2016

This study was initiated in 2004 because the prevalence of feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV) infections in feral cats in San Mateo County (SMC) was not known. The cities attributed to the feral cat population presented to the Peninsula Humane Society & SPCA’s Spay/Neuter Clinic and to the Shelter itself were analyzed to examine potential geographic concentrations of feral cats with positive retroviral status. Trends in FIV and FeLV status were examined in three 3-year periods (2001−2003, 2005−2007, and 2014−2016). Population trends over the 15 years of this study for feral cats admitted to the Shelter were also examined. In each study period, more female feral cats were presented to the S/N Clinic (54.06%, 57.37%, 54.89%). FIV prevalence increased from 5.52% to 6.41% (p = 0.29) from the first to third period; FeLV prevalence decreased significantly from 1.73% to 0.29% (p = 0.01). Significantly more FIV-positive males than females were identified each year and for each period (p < 0.01). The four largest SMC cities were the major source of feral cats to the Shelter, S/N Clinic, and of FIV- and FeLV-positive cats in the first two periods; in the third period, 50% of feral cats to the Shelter and of FeLV-positive cats were from these cities. Despite a 61.63% reduction in feral cat admissions to the S/N Clinic, the FIV prevalence for males remained similar and increased for females. The retrovirus prevalence suggests the need for continued testing and surveillance of FIV among SMC free-living cats.

Clinicopathological Findings in Cats Tested for Feline Immunodeficiency Virus (FIV) and Feline Leukaemia Virus (FeLV)

This retrospective study aimed to evaluate the clinicopathological changes in a population of cats tested for feline immunodeficiency virus (FIV) and feline leukaemia virus (FeLV), in an Italian Veterinary University Hospital, in the period between January 2002 and May 2016. During the period of 14 years, 1834 cats were tested, and of these 241/1834 (13.1%) were positive for FIV antibodies and 92/1834 (5%) cats were positive for FeLV antigen. These data confirm the presence of a high prevalence of these viruses on Italian territory. To the authors’ knowledge, this study describes findings that have never been evaluated before, such as iron status in retrovirus-infected cats and urinalysis in FeLV-positive cats. In this study, FIV-positive cats were more likely to have higher serum protein concentration and lower albumin-globulin ratio than other groups of cats. Lower urine specific gravity and higher urine protein to creatinine ratio were also detected for FIV-positive cats when compared with negative and healthy cats. FeLV-positive cats were more likely to have cytopenia, decreased haemoglobin, haematocrit and RBC compared with other groups of cats. The data obtained underline the importance of considering retroviral infections in the presence of a broad spectrum of risk factors and laboratory anomalies.

Intensive Adoption as a Management Strategy for Unowned, Urban Cats: A Case Study of 25 Years of Trap-Assess-Resolve (TAR) in Auckland, New Zealand

Globally, unowned urban cats are a major concern because they may suffer from poor welfare and cause problems, including public health risks, nuisances, and urban wildlife predation. While management options are often presented as a choice between culling or trap−neuter−return (TNR), for 25 years, the Lonely Miaow (Inc.) charity in Auckland, New Zealand (hereafter LM), has used a third strategy—intensive adoption or trap−assess−resolve (TAR). As of 2019, of 14,611 unowned cats trapped, 64.2% were adopted, 22.2% were euthanized if unsocialised or in grave ill-health, 5.7% were neutered and returned to the site, and 7.9% had other outcomes, such as being transferred to other shelters. Adoption rates increased over this time, exceeding 80.0% in 2018 and 2019. The cost of processing each cat from capture to adoption rose from NZD 58 in 1999 to NZD 234 by 2017. Approximately 80% of colonies (sites where cats were trapped) were around residential areas. Approximately 22% of cats required veterinary treatment after capture; common ailments included respiratory infections, ringworm, dental problems, and trauma. Consistently, 52% of cats were young kittens (<10 weeks old), c. 80% of cats were <1 year old, and only c. 2% were estimated to be >5 years old. TAR avoids euthanasia where possible. Its effectiveness would be enhanced by fewer abandonments of owned cats and kittens, fitting within integrated strategies for the control of unowned cats involving community education. Cat adoptions improve the welfare of cats and, with appropriate husbandry, should alleviate concerns about nuisances, public health, and attacks on wildlife or the cats themselves, essentially benefitting the community and the cats. This case study is relevant to other cities around the world that are seeking to manage unowned cats.

Risk factors and clinical and laboratory findings associated with feline immunodeficiency virus and feline leukemia virus infections in Bangkok, Thailand

Background and Aim: Feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV) are retroviruses associated with chronic and neoplastic diseases in domestic and non-domestic cats. There has been increasing interest in the clinical importance of feline retroviruses in Thailand and the identification of associated risk factors in domestic cats. To prevent the spread of retroviral diseases and improve the management of retrovirus-infected cats, risk factors and associated clinical laboratory data must be clearly understood. This study aimed to identify the influence of household, lifestyle, health status, sterilization, clinical presentations, and laboratory findings on FIV- and FeLV-infected cats in Bangkok, Thailand. Materials and Methods: A total of 480 cats were evaluated for FeLV p27 antigen and FIV antibodies using Witness FeLV-FIV Rapid Test and SNAP FIV/FeLV Combo Test at a veterinary hospital service. Results: Of the 480 cats tested, 113 were positivefor virus infection, including 60 for FeLV (12.5%), 40 for FIV (8.3%), and 13 for both FeLV and FIV (2.7%). The findings revealed that the risk factors for cats infected with FeLV, FIV, or both FeLV and FIV were significantly different compared with those for non-infected cats (p < 0.05). Multivariate analysis showed that multi-cat ownership is a risk factor for the high prevalence of feline retrovirus infection, as multi-cat households exhibited a higher prevalence of infection than single-cat households. Anemic and sick cats were also at a greater risk of testing positive for specific retrovirus infections. FeLV-infected cats had a higher risk of anemia and low erythrocyte and thrombocyte counts (p ≤ 0.0001), whereas FIV-infected cats were more likely to have anemia and leukocytopenia than controls. Conclusion: Knowledge of the risk factors for retroviral diseases and associated clinical and laboratory findings can be used to develop strategies to reduce FIV and FeLV infections in cats.

[Feline leukemia virus infection - a guide to diagnosis]

Feline leukemia virus (FeLV) infection affects cats worldwide. The course of FeLV infection can change and vary over time. The complex pathogenesis, the availability of many different testing methods, and the interpretation of test results are often challenging for veterinarians. Cats with progressive infection (persistently p27 antigen-positive) shed FeLV mainly through saliva and are therefore considered a source of infection for uninfected cats. Diagnosing regressive infection is often challenging, since it usually cannot be detected by commonly used point of care-tests (p27 antigen test) and thus, it often remains undetected. Nevertheless, cats with regressive infection are FeLV carriers (provirus-positive) and when the immune system is suppressed, reactivation of the infection and FeLV-associated clinical signs can occur. Abortively infected cats are never viraemic, do not shed virus, and do not develop clinical signs. Abortive infection can solely be diagnosed via antibodies detection in blood. A new point-of-care test for the identification of antibodies against FeLV p15E antigen has recently been introduced on the European market and is currently being evaluated.

Prevalence of feline calicivirus and the distribution of serum neutralizing antibody against isolate strains in cats of Hangzhou, China

Background

Feline calicivirus (FCV) is a common pathogen of felids, and FCV vaccination is regularly practiced. The genetic variability and antigenic diversity of FCV hinder the effective control and prevention of infection by vaccination. Improved knowledge of the epidemiological characteristics of FCV should assist in the development of more effective vaccines.

Objectives

This study aims to determine the prevalence of FCV in a population of cats with FCV-suspected clinical signs in Hangzhou and to demonstrate the antigenic and genetic relationships between vaccine status and representative isolated FCV strains.

Methods

Cats (n = 516) from Hangzhou were investigated between 2018 and 2020. The association between risk factors and FCV infection was assessed. Phylogenetic analyses based on a capsid coding sequence were performed to identify the genetic relationships between strains. In vitro virus neutralization tests were used to assess antibody levels against isolated FCV strains in client-owned cats.

Results

The FCV-positive rate of the examined cats was 43.0%. Risk factors significantly associated with FCV infection were vaccination status and oral symptoms. Phylogenetic analysis revealed a radial phylogeny with no evidence of temporal or countrywide clusters. There was a significant difference in the distribution of serum antibody titers between vaccinated and unvaccinated cats.

Conclusions

This study revealed a high prevalence and genetic diversity of FCV in Hangzhou. The results indicate that the efficacy of FCV vaccination is unsatisfactory. More comprehensive and refined vaccination protocols are an urgent and unmet need.

Molecular detection of feline leukemia virus in clinically ill cats in Klang Valley, Malaysia

Background and Aim

Feline leukemia virus (FeLV) is classified as Retroviridae gammaretrovirus. FeLV occurs worldwide, including Malaysia. Thus far, only one decade-old study on molecular characterization of Malaysian FeLV isolates exists, which resulted in a scarcity of updated information of current FeLV isolates circulating in Malaysia. This study was conducted to determine the status of FeLV in clinically ill cats and to study the molecular characterization and phylogenetic relatedness of the current isolates.

Materials and Methods

Convenience sampling was performed in 20 cats from the Gasing Veterinary Hospital in Selangor. Plasma and saliva samples were collected from 15 clinically ill cats and 5 healthy cats subjected to one-step reverse transcription-polymerase chain reaction with primers targeting a highly conserved gene of U3-LTR-gag.

Results

Two clinically ill cats' plasma and saliva samples tested positive for FeLV RNA. Partial nucleotide sequencing and phylogenetic analysis revealed that the current isolates were 94-99% homologous to the previous Malaysian and Japanese FeLV isolates.

Conclusion

Current FeLV isolates from this study displayed higher similarity with the previous Malaysian isolates, signifying that a similar FeLV strain circulated among the cat population in Selangor.

Lack of protection against feline immunodeficiency virus infection among domestic cats in New Zealand vaccinated with the Fel-O-Vax® FIV vaccine

Infections with feline immunodeficiency virus (FIV) are common in New Zealand, although the impact of those infections on the health status of the cats remains unclear. Although many cats are vaccinated yearly with a commercial FIV vaccine containing FIV subtypes A and D, the effectiveness of this vaccine in protection against infection with field FIVs is unclear, as a high proportion of New Zealand viruses belong to subtype C. The objective of the study was to compare the frequency of FIV infection among adult FIV-vaccinated and FIV-unvaccinated domestic cats with access to outdoors. Buccal swabs were collected by the participating veterinarians and tested for the presence of FIV provirus by quantitative PCR. Overall, 26/185 (14.0 %) samples were positive for FIV, including 7/82 (8.5 %) samples from FIV-unvaccinated and 19/103 (18.4 %) from FIV-vaccinated cats. There was no protective effect of vaccination on FIV infection among sampled cats (p = 0.05). Partial sequences of the FIV envelope gene from five New Zealand viruses were analysed by the maximum likelihood method. All clustered with other New Zealand FIV sequences from subtypes A (n = 2), C (n = 2) or putative recombinant viruses (n = 1). While the FIV vaccination did not prevent FIV infection among sampled cats, it may have had an impact on transmissibility of the virus or on disease progression. As neither was addressed in the current study, further research is needed to fully assess the potential benefits of FIV vaccination. Considering the frequency of FIV infection in FIV-vaccinated cats, FIV infection status should be monitored not only before the first vaccination, but before each yearly booster.

Molecular and serological investigation of cat viral infectious diseases in China from 2016 to 2019

In order to analyse the prevalence of cat viral diseases in China, including feline parvovirus (FPV), feline calicivirus (FCV), feline herpesvirus 1 (FHV-1), feline leukaemia virus (FeLV), feline immunodeficiency virus (FIV) and feline infectious peritonitis virus (FIPV), a total of 1,326 samples of cats from 16 cities were investigated from 2016 to 2019. Collectively, 1,060 (79.9%) cats were tested positive for at least one virus in nucleotide detection, and the positive rates of cat exposure to FeLV, FPV, FHV-1, FCV, FIV and FIPV were 59.6%, 19.2%, 16.3%, 14.2%, 1.5% and 0.5%, respectively. The prevalence of FHV-1 and FPV was dominant in winter and spring. Cats from north China showed a higher positive rate of viral infection than that of cats from south China. The virus infection is not highly correlated with age, except that FPV is prone to occur within the age of 12 months. In the serological survey, the seroprevalences of 267 vaccinated cats to FPV, FCV and FHV-1 were 83.9%, 58.3% and 44.0%, respectively. Meanwhile, the seroprevalences of 39 unvaccinated cats to FPV, FCV and FHV-1 were 76.9% (30/39), 82.4% (28/34) and 58.6% (17/29), respectively. This study demonstrated that a high prevalence of the six viral diseases in China and the insufficient serological potency of FCV and FHV-1 remind the urgency for more effective vaccines.

Prevalence and Genomic Diversity of Feline Leukemia Virus in Privately Owned and Shelter Cats in Aburrá Valley, Colombia

The feline leukemia virus (FeLV) belongs to the family Retroviridae; it is the first feline retrovirus discovered and one of the agents that has a great impact on cats' health and the ecology of the feline population worldwide. It is associated with the occurrence of several syndromes of fatal diseases, including the development of lymphomas. Studies on FeLV have been reported in Colombia, and most of them have been approached from a clinical point of view. However, only a few studies have focused on the prevalence of the infection, while none have clarified which variant or FeLV viral subgroup is presently circulating in our country. Therefore, the present study investigated the prevalence of the infection associated with the molecular characterization of FeLV present in cats in Aburrá Valley, Colombia. The sampling of privately owned and shelter cats was performed in female (n = 54) and male (n = 46) felines; most of them were seemingly healthy according to the owner's report, with nonspecific clinical history. Immunoassay confirmed that 59.44% (95% confidence interval (CI) = 49.81-69.06%) of felines were FeLV seropositive. The molecular testing of felines using reverse transcription-polymerase chain reaction and sequencing showed that 30% (30/100) of felines were positive, and the most prevalent subgroup in the Aburrá Valley was FeLV-A. In conclusion, the frequency of leukemia virus, as revealed by molecular and serological tests, is one of the highest reported frequencies to date, and a high molecular variation is shown in the Colombian population. More studies on the behaviour of the virus in feline populations in Columbia are warranted to determine its prevalence throughout the country.

A Preliminary Description of Companion Cat, Managed Stray Cat, and Unmanaged Stray Cat Welfare in Auckland, New Zealand Using a 5-Component Assessment Scale

Free-roaming cats are a polarizing issue in New Zealand and there is strong need for a comprehensive evaluation of their welfare to better inform population management decisions. In this study, a 5-component visual health-related welfare assessment scale was developed and piloted on a convenience sample of 213 free-roaming companion cats (CC), 210 managed stray cats (MS), and 253 unmanaged stray cats (UMS) from various locations in Auckland, New Zealand. The welfare assessment was performed through distance observation and consisted of body condition score (BCS); coat condition score; nose and eye discharge score; ear crusting score; and injury score. The majority of cats in all groups appeared generally healthy with no nose or eye discharge, ear crusting, or injuries. Although there were no appreciable differences in the apparent welfare of CC and MS cats, future studies with more robust sampling designs are needed to draw accurate inferences. The scale also requires further validation by comparing the visual observations against more detailed physical examination and biochemical data. Nonetheless, the results from this study provide preliminary information about assessing the health and welfare of stray cats as well as considerations for developing and implementing robust assessment scales.

Survival time and effect of selected predictor variables on survival in owned pet cats seropositive for feline immunodeficiency and leukemia virus attending a referral clinic in northern Italy

Feline immunodeficiency virus (FIV) and feline leukemia virus (FeLV) are among the most important feline infectious diseases worldwide. This retrospective study investigated survival times and effects of selected predictor factors on survival time in a population of owned pet cats in Northern Italy testing positive for the presence of FIV antibodies and FeLV antigen. One hundred and three retrovirus-seropositive cats, 53 FIV-seropositive cats, 40 FeLV-seropositive cats, and 10 FIV+FeLV-seropositive cats were included in the study. A population of 103 retrovirus-seronegative age and sex-matched cats was selected. Survival time was calculated and compared between retrovirus-seronegative, FIV, FeLV and FIV+FeLV-seropositive cats using Kaplan-Meier survival analysis. Cox proportional-hazards regression analysis was used to study the effect of selected predictor factors (male gender, peripheral blood cytopenia as reduced red blood cells - RBC- count, leukopenia, neutropenia and lymphopenia, hypercreatininemia and reduced albumin to globulin ratio) on survival time in retrovirus-seropositive populations. Median survival times for seronegative cats, FIV, FeLV and FIV+FeLV-seropositive cats were 3960, 2040, 714 and 77days, respectively. Compared to retrovirus-seronegative cats median survival time was significantly lower (P<0.000) in FeLV and FIV+FeLV-seropositive cats. Median survival time in FeLV and FIV+FeLV-seropositive cats was also significant lower (P<0.000) when compared to FIV-seropositive cats. Hazard ratio of death in FeLV and FIV+FeLV-seropositive cats being respectively 3.4 and 7.4 times higher, in comparison to seronegative cats and 2.3 and 4.8 times higher in FeLV and FIV+FeLV-seropositive cats as compared to FIV-seropositive cats. A Cox proportional-hazards regression analysis showed that FIV and FeLV-seropositive cats with reduced RBC counts at time of diagnosis of seropositivity had significantly shorter survival times when compared to FIV and FeLV-seropositive cats with normal RBC counts at diagnosis. In summary, FIV-seropositive status did not significantly affect longevity of cats in this study, unlike FeLV and FIV+FeLV-seropositivity. Reduced RBC counts at time of FIV and FeLV diagnosis could impact negatively on the longevity of seropositive cats and therefore blood counts should always be evaluated at diagnosis and follow-up of retrovirus-seropositive cats.

Neurologic disease in feline immunodeficiency virus infection: disease mechanisms and therapeutic interventions for NeuroAIDS

Feline immunodeficiency virus (FIV) is a lentivirus that causes immunosuppression through virus-mediated CD4+ T cell depletion in feline species. FIV infection is complicated by virus-induced disease in the nervous system. FIV enters the brain soon after primary infection and is detected as FIV-encoded RNA, DNA, and proteins in microglia, macrophages, and astrocytes. FIV infection activates neuroinflammatory pathways including cytokines, chemokines, proteases, and ROS with accompanying neuronal injury and loss. Neurobehavioral deficits during FIV infection are manifested as impaired motor and cognitive functions. Several treatment strategies have emerged from studies of FIV neuropathogenesis including the therapeutic benefits of antiretroviral therapies, other protease inhibitors, anti-inflammatory, and neurotrophic compounds. Recently, insulin's antiviral, anti-inflammatory, and neuroprotective effects were investigated in models of lentivirus brain infection. Insulin suppressed HIV-1 replication in human microglia as well as FIV replication of lymphocytes. Insulin treatment diminished cytokine and chemokine activation in HIV-infected microglia while also protecting neurons from HIV-1 Vpr protein-mediated neurotoxicity. Intranasal (IN) insulin delivery for 6 weeks suppressed FIV expression in the brains of treated cats. IN insulin also reduced neuroinflammation and protected neurons in the hippocampus, striatum, and neocortex of FIV-infected animals. These morphological and molecular effects of IN insulin were confirmed by neurobehavioral studies that showed IN insulin-treated FIV-infected animals displayed improved motor and cognitive performance compared to sham-treated FIV-infected animals. Thus, FIV infection of the nervous system provides a valuable comparative in vivo model for discovering and evaluating disease mechanisms as well as developing therapeutic strategies for NeuroAIDS in humans.