Oral Hairy Leukoplakia — SCE Infectious Diseases MCQ

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EasyHIV MedicineOral Hairy LeukoplakiaSCE Infectious Diseases

A 40-year-old man with HIV (CD4 100) develops white patches on the lateral tongue borders that cannot be scraped off. He is not on ART. What is the underlying virus?

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Correct answer: C — Epstein-Barr virus

Oral hairy leukoplakia is caused by EBV replication in lingual epithelium. The white corrugated patches on the lateral tongue borders are non-removable (unlike Candida). It occurs almost exclusively in immunosuppressed patients, particularly HIV with low CD4. It is benign and resolves with ART-induced immune reconstitution. No specific treatment is needed beyond starting ART.

Reference: BHIVA 2022 – OI guidelines; WHO 2021 – HIV staging