Final answer:
Oral hairy leukoplakia primarily occurs with HIV infection. It is associated with Epstein-Barr virus activation in individuals with weakened immune systems due to HIV, leading to characteristic white lesions in the mouth.
Step-by-step explanation:
Oral hairy leukoplakia primarily occurs with HIV (Human Immunodeficiency Virus). It is a condition characterized by the appearance of white lesions in the mouth, which is a hallmark of immunocompromise due to HIV infection. The Epstein-Barr virus (EBV) is associated with oral hairy leukoplakia in individuals with HIV, as their weakened immune systems are less able to control the proliferation of EBV-infected B cells. This can lead to the formation of the white lesions typical of leukoplakia. Notably, other conditions such as Kaposi's sarcoma, caused by a different type of herpes virus, are also associated with HIV. These opportunistic infections and malignancies highlight the profound immune system deficiencies that HIV can cause.