Treating oral hairy leukoplakia with high dose valacyclovir

Graham McKerrow, HIV i-Base

A study of 19 people (73% on HAART) with HIV-associated oral hairy leukoplakia (OHL) and Epstein-Barr virus (EBV) replication found that treatment with high dose oral valacyclovir (Valtrex), one gram every eight hours for a month, could inhibit productive replication of EBV. Walling and colleagues at the University of Texas report that in the majority of cases OHL was resolved and EBV replication was halted.

OHL was cleared in 89% of subjects. OHL and EBV replication recurred in two subjects and EBV replication alone was detected in two more subjects. The researchers theorise that either the virus developed resistance and/or subjects did not take their medication as directed.

According to the research team: “Valacyclovir appears to be a generally safe and effective option for the short-term treatment of OHL in HIV-infected patients.”


Walling DM, Flaitz CM and Nichols CM. Epstein-Barr virus replication in oral hairy leukoplakia: response, persistence, and resistance to treatment with valacyclovir. J Infect Dis. 2003 Sep 15;188(6):883-90.

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