I think the question of whether there are other, synergistic agents,
including viruses and mycoplasmas, that are involved with AIDS is still
open. It would not be surprising if there are other viruses that can
cause immunodeficiency. But the vast majority of cases of what we call
AIDS appear to be dependent on infection with HIV. Schecter and coworkers
(Lancet 341:658, 1993) studied 715 homosexual men for a median period of
8.6 years. All 136 AIDS cases they observed occurred in the 365 individuals
with pre-existing HIV-1 antibody. Most men negative for HIV-1 antibody
reported risk behaviors (use of nitrite inhalants, use of illicit drugs,
high frequency of receptive anal intercourse) but none developed AIDS or
any AIDS-related illnesses. There were 101 AIDS-related deaths in the
seropositive men. In the seronegative group, there were only 2 deaths--
this would seem to me to rule out subjective biases in making diagnoses.
Jack Komisar
