ORAL HAIRY LEUCOPLAKIA IN AN HIV-POSITIVE PATIENT: A CASE REPORT

Abstract

Our clinic received a 33-year-old male patient, complaining of an oral burning sensation and white lesions on the lateral border of the tongue for 7 months. He also reported weight loss and nausea, and was recently diagnosed with HIV (viral load of 1,260,000 copies/ml and LTCD4 of 86 cells/uL). Intraoral exam showed white, verrucous, and irregular plaques located bilaterally on the tongue. An incisional biopsy was performed and anatomopathological examination showed superficial squamous epithelium with ballooning epithelial cells with bare nuclei, confirming the diagnosis Oral Hairy Leucoplakia (OHL). The in-situ hybridization for Epstein-Barr Virus (EBER) was positive. The patient began antiretroviral treatment, taking dolutegravir, tenofovir, and lamudivine. One month later, he presented undetectable viral load and LTCD4 of 294 cells/uL. After 2 months of follow-up, OHL showed complete clinical regression. AIDS is under control in Brazil, but clinicians must bear in mind the diagnosis of OHL in HIV+ patients. Our clinic received a 33-year-old male patient, complaining of an oral burning sensation and white lesions on the lateral border of the tongue for 7 months. He also reported weight loss and nausea, and was recently diagnosed with HIV (viral load of 1,260,000 copies/ml and LTCD4 of 86 cells/uL). Intraoral exam showed white, verrucous, and irregular plaques located bilaterally on the tongue. An incisional biopsy was performed and anatomopathological examination showed superficial squamous epithelium with ballooning epithelial cells with bare nuclei, confirming the diagnosis Oral Hairy Leucoplakia (OHL). The in-situ hybridization for Epstein-Barr Virus (EBER) was positive. The patient began antiretroviral treatment, taking dolutegravir, tenofovir, and lamudivine. One month later, he presented undetectable viral load and LTCD4 of 294 cells/uL. After 2 months of follow-up, OHL showed complete clinical regression. AIDS is under control in Brazil, but clinicians must bear in mind the diagnosis of OHL in HIV+ patients.