Comparison of the efficacy of surgery and acyclovir therapy in oral hairy leukoplakia

Herbst, Jay S.; Morgan, J.; Raab‐Traub, Nancy; Resnick, Lionel

doi:10.1016/s0190-9622(89)70250-4

Cited by 45 publications

(20 citation statements)

References 16 publications

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“…HLP is the only EBV-associated disease in which acyclovir, an antiviral drug that inhibits the replication of EBV, induces clinical remission (2). This response and the detection of masses of viral particles in the infected cells make these lesions unique in EBV biology and indicate that the virus is actively replicating (1,2).Replication is relatively unusual in EBV-infected cells. Although the virus replicates in oropharyngeal epithelial cells, the transforming infection of B lymphocytes, which is the hallmark of EBV infection, is largely nonpermissive (3-6).…”

mentioning

confidence: 99%

“…Epstein-Barr virus (EBV), usually thought of as a lymphotrophic herpesvirus, is the etiologic agent of this mucocutaneous epithelial cell disorder. HLP is the only EBV-associated disease in which acyclovir, an antiviral drug that inhibits the replication of EBV, induces clinical remission (2). This response and the detection of masses of viral particles in the infected cells make these lesions unique in EBV biology and indicate that the virus is actively replicating (1,2).…”

mentioning

confidence: 99%

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Epstein-Barr virus small nuclear RNAs are not expressed in permissively infected cells in AIDS-associated leukoplakia.

Gilligan

Rajadurai

Resnick

et al. 1990

Proc. Natl. Acad. Sci. U.S.A.

172

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Epstein-Barr virus (EBV) DNA structure and gene expression were analyzed in tissue specimens from oral hairy leukoplakia (HLP), a mucocutaneous lesion that develops in patients infected with human immunodeficiency virus (HIV). The structure of the terminal restriction enzyme fragments of EBV revealed that HLP is a permissive infection without a predominant, detectable population of EBV episomal DNA. In RNA preparations from this uniquely permissive infection, EBV replicative mRNAs could be identified by Northern analysis; however, the virally encoded small nuclear RNAs, the EBERs, were not detected in most HLP RNA preparations. In situ hybridization detected EBER expression in very rare cells. These data indicate that unlike other viral small nuclear RNAs, the EBERs are not expressed during viral replication and must participate in the complex maintenance of latent EBV infection.Oral hairy leukoplakia (HLP) is a newly recognized lesion, most often located on the tongue, that occurs almost exclusively in patients with human immunodeficiency virus (HIV) infection (1). Epstein-Barr virus (EBV), usually thought of as a lymphotrophic herpesvirus, is the etiologic agent of this mucocutaneous epithelial cell disorder. HLP is the only EBV-associated disease in which acyclovir, an antiviral drug that inhibits the replication of EBV, induces clinical remission (2). This response and the detection of masses of viral particles in the infected cells make these lesions unique in EBV biology and indicate that the virus is actively replicating (1,2).Replication is relatively unusual in EBV-infected cells. Although the virus replicates in oropharyngeal epithelial cells, the transforming infection of B lymphocytes, which is the hallmark of EBV infection, is largely nonpermissive (3-6). In the latently infected B-cell lines, the viral DNA is maintained as an episome (7,8). Permissive infection develops in a small subset of cells with the expression of multiple replicative RNAs and the generation of the linear, virion form of DNA. The structure of the EBV termini permits discrimination between the linear and episomal DNA forms and therefore between permissive and latent states (9, 10).In EBV-infected cells, the most abundantly expressed viral transcripts are the nonpolyadenylylated polymerase III transcripts, EBER1 and EBER2 (EBV-encoded small nuclear RNA), which are found in ribonucleoprotein particles (RNP) (11,12). Despite their abundance, the function ofthese RNAs is unknown. The EBERs can partially substitute for the similarly sized polymerase III virus-associated (VA) transcripts encoded by adenovirus that function during viral replication (13,14). This complementation suggested that perhaps, like the VA RNAs, the EBERs also function during lytic replication. This observation was supported by studies that revealed that the EBERs are more abundant in the partially permissive virus-producer cell line B95-8 than in a latently infected lymphoid line, IB4, established by infection with B95-8 virus (15, 16). However, in co...

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mentioning

confidence: 99%

mentioning

confidence: 99%

Epstein-Barr virus small nuclear RNAs are not expressed in permissively infected cells in AIDS-associated leukoplakia.

Gilligan

Rajadurai

Resnick

et al. 1990

Proc. Natl. Acad. Sci. U.S.A.

172

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“…Hairy leukoplakia responds to ACV treatment, as might be expected since the disease is not associated with latently EBVinfected proliferating cells (62). However, the disease recurs, perhaps as a result of development of resistant virus.…”

Section: Ebvmentioning

confidence: 71%

"The end of innocence" revisited: resistance of herpesviruses to antiviral drugs

Field¹,

Biron²

1994

Clin Microbiol Rev

171

109

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In the past 4 years, interest in drug-resistant herpesviruses has evolved from the realm of academic laboratory studies to that of great clinical importance. Recurrent and persistent infections due to the herpes simplex viruses, varicella-zoster virus, and human cytomegalovirus have been an unwelcome consequence of immunosuppression in graft recipients, cancer patients, and those suffering from AIDS. Treatment of these infections with the available antiviral drugs, such as acyclovir, ganciclovir, and foscarnet, has resulted in both clinical benefit and the emergence of drug-resistant variants. In addition, the role of Epstein-Barr virus is being clarified for an array of disease syndromes, and therapeutic approaches are beginning to emerge. In the present review, the emergence and clinical importance of drug resistance among the herpesviruses have been explored. Furthermore, particular attention has been focused on our understanding of the mechanisms of drug resistance and how that understanding will guide us in the development of more effective antiviral drugs and drug usage.

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“…Although EBV is found in the oral cavity with or without oral hairy leukoplakia [37], and hairy leukoplakia does not routinely require treatment, studies have shown that the advanced lesions usually respond to short-term oral acyclovir [38,39], desciclovir [40], and valacyclovir [41], with restoration of the normal epithelial architecture within 2 to 4 weeks. In most cases, EBV replication subsides and the hairy leukoplakia lesion resolves.…”

Section: Antiviral Treatmentmentioning

confidence: 99%

Virologic diagnosis, viral monitoring, and treatment of epstein-barr virus infectious mononucleosis

Jenson

2004

Curr Infect Dis Rep

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Epstein-Barr virus (EBV) is the cause of infectious mononucleosis and is associated with severe infections in immunocompromised patients. EBV is also causally linked with several human malignancies. The heterophile antibody test and EBV-specific antibody tests remain the principal means of diagnosis of initial infection in otherwise healthy patients. Enzyme-linked immunosorbent assays have replaced the traditional immunofluorescence assays for EBV-specific antibodies. Several newer molecular diagnostic tests have become available that facilitate accurate monitoring of infection. The role of these tests for patients with uncomplicated infectious mononucleosis is limited, although these tests are being increasingly used to monitor the state and level of EBV replication for severe infections and among immunocompromised patients. Antiviral therapy has a limited, short-term effect on oropharyngeal shedding but has proven ineffective for the clinical manifestations of infectious mononucleosis. Patients with selected complications frequently benefit from short-term corticosteroid therapy.

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Comparison of the efficacy of surgery and acyclovir therapy in oral hairy leukoplakia

Cited by 45 publications

References 16 publications

Epstein-Barr virus small nuclear RNAs are not expressed in permissively infected cells in AIDS-associated leukoplakia.

Epstein-Barr virus small nuclear RNAs are not expressed in permissively infected cells in AIDS-associated leukoplakia.

"The end of innocence" revisited: resistance of herpesviruses to antiviral drugs

Virologic diagnosis, viral monitoring, and treatment of epstein-barr virus infectious mononucleosis

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