Epstein-Barr virus gene expression and epithelial cell differentiation in oral hairy leukoplakia

Hairy leukoplakia (HL) is an Epstein-Barr (EB) virus related lesion of oral mucosa that is principally associated with human immunodeficiency virus-induced immunosuppression. To understand the nature of EB virus involvement in these lesions, this study compares the distribution of EB virus DNA and EB viral gene products with the pattern of keratinocyte differentiation in 12 lateral tongue biopsies of HL. Evidence of replicating EB viral infection and abundant virus production was demonstrated in the superficial epithelium of most (92%) samples by means of in situ hybridization and immunocytochemical techniques. Epstein-Barr virus latent membrane protein also was identified in 45% of samples, suggesting that this viral gene product, which is usually associated with EB virus latent infection, may be transiently expressed during viral replication in HL epithelium. The absence of detectable EB virus involvement in basal keratinocytes, however, fails to support the theory that latent infection occurs in basal epithelium. From this study, EB viral gene expression in HL appears to be linked with epithelial maturation. Conversely, the normal patterns of keratinocyte differentiation in these lesions do not appear to be appreciably altered by association with EB virus.