What is the prognosis of hairy leukoplakia?

Updated: Aug 05, 2019
  • Author: James E Cade, DDS; Chief Editor: Jeff Burgess, DDS, MSD  more...
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Answer

The majority of patients with oral hairy leukoplakia (OHL) tend to have significant immunosuppression at the time of diagnosis. Oral hairy leukoplakia occurs relatively soon after HIV seroconversion, typically before AIDS. Median CD4 count when oral hairy leukoplakia is first detected is 235-468/µL. Another study showed oral hairy leukoplakia occurred mostly in patients with CD4 counts of 200-500/µL. [20]

In patients with HIV, the median CD4 count when oral hairy leukoplakia is first detected is 468/µL. If these patients do not have AIDS-defining disease at the time oral hairy leukoplakia is diagnosed, the probability of developing AIDS if not receiving highly active antiretroviral therapy (HAART) is 48% by 16 months and 83% at 31 months. In addition, studies have shown that patients with AIDS with oral hairy leukoplakia have a shorter lifespan than those who do not present with this lesion. Furthermore, if these patients are concomitantly co-infected with hepatitis B virus, the risk of early progression to AIDS increases 4-fold. Further studies in HIV-seropositive patients show that the median survival after the diagnosis of oral hairy leukoplakia is around 20 months. In patients with CD4 count greater than or equal to 300/μL, oral hairy leukoplakia is associated with median survival time of 25 months, compared with 52 months in patients with normal counts. [21]


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