Oral ulcers in AIDS patients frequently associated with cytomegalovirus (CMV) and Epstein-Barr virus (EBV) infections

Oral ulcers are common in AIDS patients, with a wide spectrum of underlying causes, including different viruses. Tn the present study, the presence of cytomegalovirus (CMV), Epstein-Barr virus (EBV) and human herpesvirus-8 (H HV-8) DNA was analysed in 21 biopsies from oral ulcers of 17 male homosexua l AIDS patients. The methods used were in situ hybridization (ISH) and the polymerase chain reaction (PCR) with subsequent non-radioactive Southern bl ot hybridization to confirm the specificity of PCR products. With ISH, 4 bi opsies were CMV DNA-positive and 11 contained EBV-DNA. Using PCR, an additi onal 4 CMV- and 7 EBV-positive samples were detected, and HHV-8 DNA was pre sent in three oral ulcers. Six of the patients (35%) had oral ulcers co-inf ected by two or three viruses. The overall figures for patients with the de tectable EBV-, CMV-, and HHV-8 DNA were 82% (14/17), 35% (6/17) and 18% (3/ 17), respectively. This is the first study to show the frequent presence of EBV-DNA in oral ulcers of AIDS patients. Because ISM-positivity signifies active virus replication, these results implicate an etiological role of EB V in AIDS-associated oral ulcers. The causal role of HHV-8 has to be consid ered as well, because this virus was detected in three such ulcers, which w ere not associated with Kaposi's sarcoma. To conclude, three common members of the herpesvirus family (CMV, EBV HHV-8) were detected in all but three ulcers in AIDS patients, warranting the inclusion of these viral analyses i n the diagnosis of ulcerative lesions of the oral mucosa in all immunosuppr essed individuals.