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Persistent productive Epstein-Barr virus replication in normal epithelial cells in vivo
D M Walling1, C M Flaitz, C M Nichols
1Division of Infectious Diseases, Dept. of Internal Medicine, University of Texas Medical Branch at Galveston, TX 77555-0435, USA. dwalling@utmb.edu
The Journal of Infectious Diseases
|December 12, 2001
Summary
Valacyclovir treatment resolved oral hairy leukoplakia by stopping Epstein-Barr virus (EBV) replication in HIV-infected individuals. EBV replication returned in normal oral cells post-treatment, indicating persistent infection.
Area of Science:
- Oral pathology
- Virology
- Immunology
Background:
- Oral hairy leukoplakia is an oral epithelial lesion associated with Epstein-Barr virus (EBV) productive replication.
- It commonly affects individuals with human immunodeficiency virus (HIV) infection.
Purpose of the Study:
- To investigate the role of EBV replication in oral hairy leukoplakia pathogenesis.
- To assess the efficacy of valacyclovir in treating EBV-associated oral lesions in HIV-infected patients.
Main Methods:
- Serial tongue biopsies from HIV-infected subjects before, during, and after valacyclovir treatment.
- Detection of EBV replication using Southern hybridization, RT-PCR, immunohistochemistry, and in situ hybridization.
Main Results:
- EBV replication was detected in both hairy leukoplakia and normal tongue tissues.
- Valacyclovir treatment eradicated EBV replication in vivo and led to hairy leukoplakia resolution.
- EBV replication recurred in normal oral epithelium after treatment cessation.
Conclusions:
- Normal oral epithelium harbors persistent EBV infection in HIV-infected individuals.
- Productive EBV replication is necessary, but not sufficient, for oral hairy leukoplakia development.

