Hairy leukoplakia is typically non-cancerous and commonly associated with which infection?

• A. Hepatitis C infection
• B. HIV infection
• C. HBV infection
• D. HPV infection

Answer: (B)

Hairy leukoplakia occurs in the setting of immune suppression, most classically with HIV infection. It’s caused by Epstein-Barr virus infecting oral mucosa and presents as non-scrapable, corrugated white plaques on the lateral tongue. The key point is that these lesions are benign, but their appearance signals underlying HIV-related immunosuppression and may improve with immune reconstitution on antiretroviral therapy. The other infections listed are not typically associated with hairy leukoplakia—HPV is linked to warts and some oropharyngeal cancers, while HBV and HCV affect the liver.