Replication of Epstein-Barr virus within the epithelial cells of oral "hairy" leukoplakia, an AIDS-associated lesion

N Engl J Med. 1985 Dec 19;313(25):1564-71. doi: 10.1056/NEJM198512193132502.


We conducted a study to identify the viruses in tissue specimens of oral "hairy" leukoplakia, a lesion that is found in immunosuppressed male homosexuals and that is associated with the subsequent development of the acquired immunodeficiency syndrome. When stained for papillomavirus core antigen, 49 of 67 biopsy specimens (73 per cent) yielded positive results in epithelial-cell nuclei. Electron microscopy showed papillomavirus-like particles in all of 25 specimens, and the herpes-type virus described in a previous report was seen in 23 of the 25 specimens. Three specimens had both types of particle in the same individual epithelial cells. Immunofluorescence for herpes simplex virus, varicella-zoster virus, and cytomegalovirus gave negative results in all cases, but 19 of 20 specimens showed intense nuclear staining in epithelial cells for the viral capsid antigen of Epstein-Barr virus (EBV). DNA hybridization using EBV probes in Southern blots demonstrated EBV DNA in all of 13 specimens and found 200 or more viral DNA molecules per cellular genome in 11 of the 13. The whole EBV genome was also demonstrated in the specimens and found to be in linear virion form. We conclude that EBV replicates within the epithelial cells in hairy leukoplakia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acquired Immunodeficiency Syndrome / complications*
  • Antibodies, Viral / analysis
  • Antigens, Viral / analysis
  • Capsid / immunology
  • DNA, Viral / analysis
  • Epithelium / microbiology
  • Genes, Viral
  • Herpesvirus 4, Human / genetics
  • Herpesvirus 4, Human / growth & development*
  • Herpesvirus 4, Human / immunology
  • Homosexuality
  • Humans
  • Immunoglobulin G / analysis
  • Leukoplakia, Oral / microbiology*
  • Leukoplakia, Oral / ultrastructure
  • Male
  • Nucleic Acid Hybridization
  • Papillomaviridae / immunology
  • Tongue Neoplasms / microbiology*
  • Tongue Neoplasms / ultrastructure
  • Virion
  • Virus Replication


  • Antibodies, Viral
  • Antigens, Viral
  • DNA, Viral
  • Immunoglobulin G