OHL as only symptom..or not OHL at all??

Question

Please help with this question. I'm very confused and I am driving myself crazy with worry. First, for the past year I have had two small strips of white on the top sides of my tongue towards the back. These will wipe away when I brush my teeth, but they will return periodically. This is accompanied by a bitter taste in my mouth. I know that I am a cheek biter and I thrust my tongue (I have the little indentions in my tongue in the morning from my teeth). I have been very paranoid that the white strips are possibly OHL. From my presentation, does this sound like a possibility? Also, would it be likely that one would have OHL for a year with absolutely no other symptoms if they were HIV+? Please answer if possible, I would very much like to have an HIV test to get this off of my mind. However, I will be without health insurance for another two months and I'm scared to death to test without it.

Answer

Oral hairy leukoplakia (OHL), in the vast majority of cases, presents on the sides of the tongue, not the top or top sides. In other words, OHL tends to present on the smooth, softer lateral portions of the tongue.

Whereas I imagine it is possible to have OHL as the only sign of HIV infection, I would think this not common as most studies have shown this presentation to be seen when the T-cell count is at or around 200.

Again, if you feel you may be at risk for HIV infection, please take the diagnostic test. If this is your only sign or symptom, I do not believe any harm will come from waiting until your insurance is active.

Sincerely,

DR