Brehmer-Andersson E, Lucht E, Lindskog S, Ekman M, Biberfeld P
Department of Pathology, Södersjukhuset, Stockholm, Sweden.
Acta Derm Venereol. 1994 Mar;74(2):81-9. doi: 10.2340/00015555748189.
Oral hairy leukoplakia in HIV-seropositive persons is considered as a highly serious sign and places the patient in the AIDS-related complex group according to the classification recommended by the Centers for Disease Control. Epstein-Barr virus (EBV) is thought to be the cause. Based on the investigation of 14 of our own cases and a review of the literature, we conclude that so called hairy leukoplakia does not have a specific histopathologic pattern. Identical lesions can be caused by fungus infection, or biting and other kinds of mechanical irritation. Both fungal infection and EBV infection have been proven in a high percentage of the lesions. However, EBV has been found also in apparently normal oral mucosa. This questions the assumption that the virus is the cause of the lesions. In our investigation the presence of "hairy leukoplakia" did not reflect the clinical status of the patient. The best indicator of the clinical status was the T-lymphocyte subset CD4+ number in the peripheral blood. It appears that low CD4+ counts, candidiasis and the presence of replicating EBV in the epithelial cells are parallel markers of increasing immunodeficiency.
在人类免疫缺陷病毒血清反应阳性者中，口腔毛状白斑被视为一种非常严重的体征，根据疾病控制中心推荐的分类标准，这类患者属于艾滋病相关综合征组。据认为，爱泼斯坦-巴尔病毒（EBV）是其病因。基于对我们自己的14个病例的调查以及对文献的回顾，我们得出结论，所谓的毛状白斑并没有特定的组织病理学模式。相同的病变可由真菌感染、咬伤及其他机械性刺激引起。在相当比例的病变中已证实同时存在真菌感染和EBV感染。然而，在看似正常的口腔黏膜中也发现了EBV。这对该病毒是病变病因这一假设提出了质疑。在我们的调查中，“毛状白斑”的存在并不能反映患者的临床状况。临床状况的最佳指标是外周血中T淋巴细胞亚群CD4+的数量。看来，CD4+计数降低、念珠菌病以及上皮细胞中存在复制性EBV是免疫缺陷加重的平行指标。
