Oral Hairy Leukoplakia in HIV-Infected Patients One of the early manifestations of human immunodeficiency virus (HIV) infection is oral hairy leukoplakia. These lesions occur primarily on the tongue and often precede the development of the acquired immunodeficiency syndrome. Evidence suggests that oral hairy leukoplakia is of viral origin, and both Epstein-Barr virus and the papillomavirus have been implicated. Oral hairy leukoplakia is not known to resolve spontaneously.
Currently, the only antiviral agent specifically approved for use in the treatment of HIV infection is zidovudine. Kessler and associates report that oral zidovudine therapy may be effective in the treatment of oral hairy leukoplakia. The authors describe two patients who had HIV infection and oral hairy leukoplakia that responded to zidovudine.
Both patients received 200 mg every four hours for a total of six to seven weeks. In one patient, the tongue lesions had partially regressed after four weeks of therapy and had completely resolved after seven weeks of therapy. This patient noted improvement in his physical well-being and appetite. The other patient also received acyclovir therapy for anal herpes. After one week of treatment with zidovudine, he noted partial resolution of the tongue lesions and significant improvement in physical well-being. Complete resolution of the oral hairy leukoplakia occurred after six weeks of zidovudine therapy.
It could not be determined whether resolution of oral hairy leukoplakia was due to a direct antiviral action of zidovudine or to an indirect effect on immune function. Because of its expense and potential bone marrow toxicity, zidovudine should be reserved for those patients who meet the current approved criteria for use of this drug. (Archives of Internal Medicine, November 1988, vol. 148, p. 2496.)
COPYRIGHT 1989 American Academy of Family Physicians
COPYRIGHT 2004 Gale Group
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