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Objective To study the incidence rates, clinical charateristics of oral hairy leukoplakia (OHL) and its relation to the immune status in a sample of human immunodeficiency virus (HIV) -infected adults in Yunan, China. Methods 1 060 adult patients with HIV from January 2008 to June 2010 were evaluated. The age, gender, education grade, diagnosis time of HIV-infected, route of transmission, xerostomia, oral candidiasis, high active antiretroviral therapy and CD4 lymphocytes counts. The occurrence of OHL was recorded by oral examination. The relationship of CD4 lymphocytes counts and the incidence of OHL were analyzed by statistical methods. Results There were 94 OHL patients in 1 060 HIV patients (8.9%). The average age of the OHL patients was (39.33±10.45) years old. 90% OHL was found on the two lateral aspect of the tongue. The CD4 lymphocytes of 70.2% OHL patients were less than 200 mm"3. Conclusion OHL is a frequent finding in patients with indicates severe immunosuppression and associated with the reduction of CD4 lymphocytes. [ABSTRACT FROM AUTHOR]