Relation of oral hairy leukoplakia to infection with the human immunodeficiency virus and the risk of developing AIDS.

We investigated the relation of oral hairy leukoplakia (HL) to human immunodeficiency virus (HIV) infection and to the presence or development of AIDS. All 155 patients with HL seen in our clinic were immunosuppressed homosexual men. Of 101 serum samples obtained from patients in this group who did not have AIDS, 100 showed antibodies to HIV. HIV was recovered from peripheral blood mononuclear cells of 22 of 28 patients tested. Most serum samples examined by immunoblot assay reacted with the viral envelope and gag gene precursors gp160 and p55. Of the 155 patients, 12 had AIDS at the time of diagnosis, and the syndrome developed in an additional 43 patients in one to 31 months. Survival analysis showed that the probability of AIDS developing in patients with HL was 48% by 16 months and 83% by 31 months. We conclude that oral HL is highly predictive of the development of AIDS.