Relation of Oral Hairy Leukoplakia to Infection with the Human Immunodeficiency Virus and the Risk of Developing AIDS

Abstract

We investigated the relation of oral hairy leukoplakia (HL) to human immunodeficiency virus (HIV) infection and to the presence or development of AIDS. All 155 patients with HL seen in our clinic were immunosuppressed homosexual men. Of 101 serum samples obtained from patients in this group who did not have AIDS, 100 showed antibodies to HIV. HIV was recovered from peripheral blood mononuclear cells of 22 of 28 patients tested. Most serum samples examined by immunoblot assay reacted with the viral envelope and gag gene precursors gp160 and p55. Of the 155 patients, 12 had AIDS at the time of diagnosis, and the syndrome developed in an additional 43 patients in one to 31 months. Survival analysis showed that the probability of AIDS developing in patients with HL was 48% by 16 months and 83% by 31 months. We conclude that oral HL is highly predictive of the development of AIDS.

Epstein-Barr Virus (EBV)-Infected Monocytes Facilitate Dissemination of EBV within the Oral Mucosal Epithelium

“…EBV infects about 90% of the human population, but in most immunocompetent individuals EBV persists in latent form and does not cause any significant disease. During human immunodeficiency virus (HIV)-associated immunosuppression, however, EBV may reactivate and may be associated with development of a benign lesion of oral mucosal epithelium known as hairy leukoplakia (HL) (12)(13)(14). The histopathology of HL includes acanthosis, irregular hyperparakeratosis, and balloon cell formation within the spinosum and granulosum layers of the epithelium, which may result from high-level EBV replication (14).…”

Oral Hairy Leukoplakia Which Occurred as a Presenting Sign of Acute Myeloid Leukemia in a Child

“…Since the first report in 1984, OHL has been observed mainly in AIDS patients 4,[22][23][24] . However, OHL has been reported in other immunosuppressed patients, including those with ulcerative colitis, pemphigus vulgaris, bullous pemphigoid, Behcet's syndrome, multiple myeloma, and leukemia 5,6,16,17,25 .…”

A retrospective analysis of oral hairy leukoplakia in South Australia

“…Other international studies have since found OHL to be a marker of immunosuppression and progression of HIV disease. [9][10][11][12]15 The diagnosis of OHL in this study was based on presumptive criteria as outlined by the 1993 ECClearinghouse-WHO criteria. 3 These diagnostic criteria require the lesions are white and present on the lateral border of the tongue.…”

“…[9][10][11][12][13] The role of OHL as an indicator of HIV progression in Australian populations has not been described. This analysis of OHL in a South Australian HIV-infected population was carried out in order to gain more information on the lesion in the Australian setting.…”