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HIV — SCE Infectious Diseases MCQ

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EasyHIV MedicineHIVSCE Infectious Diseases

A 40-year-old HIV-positive man (CD4 count 50 cells/µL) presents with painless white plaques on the lateral border of the tongue that cannot be scraped off. What is the most likely diagnosis?

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Correct answer: C — Oral hairy leukoplakia

Oral hairy leukoplakia is caused by Epstein-Barr virus replication in tongue epithelium and presents as white, corrugated, non-removable plaques on the lateral tongue borders. It is typically seen in immunocompromised patients, particularly those with HIV and low CD4 counts. Unlike oral candidiasis, the plaques cannot be scraped off. It is benign and usually resolves with immune reconstitution on ART. No specific treatment is required other than ART initiation.

Reference: BHIVA 2022 – Opportunistic infection guidelines; WHO 2021 – HIV clinical staging