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Oral hairy leukoplakia (OHL); when does it appear?
Sep 2, 2002

Can OHL appears before HIV seroconversion while antibody test still negative or it can only appears in later stage of the disease? Thanks

Response from Dr. Dezube

Oral hairy leukoplakia (OHL) is caused by a viral infection in the mouth (Epstein Barr Virus infection). It is seen relatively frequently in HIV-positive individuals, particularly those with a low CD4 count. However, it can also be seen in HIV-negative individuals. So to answer your question, can one get OHL and be HIV-negative?-- the answer is yes, though somewhat unlikely. I have seen many patients whose OHL improved as the CD4 counts go up.

I should note for those unfamiliar with this entity, that OHL typically appears as white ridges under the tongue. Thrush can also appear as white spots on the tongue or in the oral cavity. Thrush, however, can be easily scraped off by a tongue depressor. OHL, however, can NOT be scraped off. This helps a health professional differentiate between OHL and thrush.


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