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Indonesian pediatric population infected with Human Immunodeficiency Virus (HIV) has increased drastically in recent years. The number of new infection among infants and children (< 4 years) multiplied in 2010-2016. However, since healthcare and laboratory facilities are scare to many areas in the country, many children living with HIV are still left undiagnosed and unaware of their status. Oral Hairy Leukoplakia (OHL) as HIV-associated oral manifestation can be a useful marker in making presumptive diagnosis and prediction of the course of HIV. However, Indonesian study on OHL in pediatric HIV-infected population is still lacking, thus the study aim was to evaluate the correlation of OHL based on the use of Highly Active Antiretroviral Therapy (HAART) and immunosuppression degree among HIV-infected Indonesian pediatric patient. HIV-infected pediatric patients attending the outpatient clinic, Intermediate Care and Infectious Disease Centre (UPIPI), Dr. Soetomo Hospital between June-October 2017 were examined intraorally for the presence of OHL. Other relevant data were collected from interview to parents/guardians and patients’ medical records for further analysis. Four (14.29%) patients showed to have OHL at examination and were severely immunosuppressed (mean CD4 counts= 74cells/mm³). Statistical analysis using chi-square test confirms a significant correlation between OHL and HAART (P=0.027 P<0.05). Correlation between OHL and degree of immunosuppression have very significant correlation (P =0.003 P<0.01). The presence of OHL may indicate a high probability that infected children are in declining CD4+ counts to AIDS or experiencing treatment failure. Through immediate follow up, mortality can be prevented. [ABSTRACT FROM AUTHOR]

We present three cases of oral hairy leukoplakia (OHL) in whom the diagnosis was established by EBV DNA detection in whole saliva. Three HIV‐infected patients came to the Oral Medicine Clinic with similar chief complaints of asymptomatic white lesions on the tongue. All patients were diagnosed with suspected OHL and oral thrush also in the first patient. A multiplex PCR DNA microarray was performed to detect EBV DNA in saliva collected by spitting method. All saliva samples showed positive results for EBV DNA, and the definitive diagnosis of OHL was made. Resolution of lesions was found at 1‐ to 2‐month follow‐up after treatment with application of acyclovir 5% cream 5 times daily. Additionally, anti‐fungal treatment was given to the first patient and anti‐retroviral treatment to the first and second patients. EBV is mostly transmitted by asymptomatic shedding into saliva. Therefore, the detection of salivary EBV DNA is useful in establishing a definitive diagnosis of OHL allowing more effective treatment for both HIV‐infected patients receiving ART and treatment‐naïve patients at any CD4 + count. [ABSTRACT FROM AUTHOR]