What is it?
The oral hairy leukoplakia (OHL in English) refers to a white board - white plates or - that may develop in the mouth. These boards usually occur along the tongue side, although sometimes they can develop in the top and base of the tongue or along the inside of the cheek. Looking closely at these cards, they can look disheveled or may contain a number of small folds or ridges.
OHL may seem cold sore, another common condition characterized by white patches that can develop in the mouths of HIV-positive people. However, the cold sore usually comes out when scraped with a toothbrush, while OHL not.
OHL is usually one of the first opportunistic infections occur in HIV-positive people. It can occur in either T-cell counts. HIV-positive with over 500 T-cells developed OHL, but it is more common among HIV-positive people under 200 T-cells. It is also important to note that OHL can occur in people with healthy immune systems, including those who are not infected with HIV.
This disease is considered benign, meaning that it rarely causes serious physical problems and does not develop more complications sérias.O OHL is caused by the Epstein-Barr virus (EBV in English). Most people in the world are infected with EBV. Only in some people, including those with compromised immune systems, cause disease.
More than 25% of HIV-positive people develop OHL at some point during the course of their infection. It is more common among men and smoking HIV-positive.
What is and what symptoms?
A Progressive Multifocal Leukoencephalopathy (PML, in English) is an infection in the brain that life-threatening and can occur in people living with HIV. It is caused by a virus - the JC virus. "JC" are the initials of the first patient to be diagnosed with PML. The polyoma virus is a virus of the family which includes human papillomavirus (HPV).
The "progressive" term in PML means that it continues to get worse and usually leads to severe brain damage. The term "multifocal" means that the virus "JC" cause diseases in various parts of the brain. The "leukoencephalopathy" means that the disease affects the white matter of the brain. More specifically, the JC virus infects brain cells called oligodendrocytes. These cells are responsible for producing myelin, a fatty substance that helps protect the nerves in the brain. If too much myelin is lost and not replaced by oligodendrocytes, the nerves are damaged and often stop working correctly.
More than 85% of adults worldwide are infected with the JC virus, usually during the early years of childhood. However, the virus becomes active only in people who have active immune system. This includes people undergoing immunosuppressive chemotherapy for cancer and people with compromised immune systems due to HIV. Before the use of combination antiretroviral therapy (ART), it was estimated that between 3 and 7 percent of people with AIDS developed PML. It usually occurs in people with very low CD4 cell count (less than 100), but was seen in some HIV-infected persons with CD4 500 cell count.
In the early years of the AIDS epidemic, the PML was often progressive and fatal. Death occurred between 1 and 4 months after the onset of symptoms. While the diagnosis of PML today remains rapid in progression and possibly fatal, improvements in our ability to stabilize the immune system using HIV drugs have helped improve the prognosis associated with this opportunistic infection.
PML symptoms include mental deterioration, loss of vision, speech disorders, ataxia (inability to coordinate movements), paralysis, and coma. In rare cases, seizures can occur. As injuries and nerve damage can occur in any part of the brain, the first symptoms may be different among people with the disease.
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