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Eleni Papadopulos-Eleopulos,
Department of Medical Physics, Royal Perth Hospital, Western Australia, 6001,
Valendar F Turner, John Papadimitriou, Barry Page, David Causer, Helman Alfonso, Sam Mhlongo, Todd Miller, Christian Fiala

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In his rapid response "CD3 CD4 and all the more modern names", 3 September 2004, Nicholas Bennett wrote: "One has to ask just how the person got a CD4 count of less than 50 per microliter prior to HAART, the normal range being at the lowest ten times greater!"

A person can get CD4 counts of less than 50 per microliter and immune suppression by repeated exposure to: drugs,1 2 semen, 3-6 Factor 8,7-9 and malnutrition.10

Whatever the cause(s) of the decreased T4 cell count in AIDS patients, it cannot be "HIV".

We have pointed out in our previous rapid responses ("Is our analysis of the Zagury paper correct?", 31 August, that as far back as 1986 Gallo showed that "HIV" is neither sufficient nor necessary for the decrease in T4 in patients belonging to the AIDS risk groups. One year earlier Montagnier wrote: "This syndrome occurs in a minority of infected persons, who generally have in common a past of antigenic stimulation and of immune depression before LAV infection". As far back as 1983 Levy wrote: "We propose that this syndrome is an opportunistic infection. The AIDS agent causes disease only in those individuals who are already immunocompromised. Homosexual men, intravenous drug abusers, haemophiliacs and newborn children…all have one characteristic in common – they may be chronically immunossuppressed by antigen overload, multiple infections, drugs, or in the case of infants, immunonaive.11

Since immune deficiency (T4 decrease) precedes "HIV" infection the cause must be other than "HIV".


1. Nicolosi A, Musico M, Saracco A, Molinari S, Ziliani N, Lazzarin A. Incidence and risk factors of HIV infection: A prospective study of seronegative drug users from Milan and Northern Italy, 1987-1989. Epidemiology 1990;1:453-459.

2. Des Jarlais DC, Friedman SR, Marmor M, Mildvan D, Yancovitz S, Sotheran JL, et al. CD4 lymphocytopenia among injecting drug users in New York City. J Acquir Immun Defic Syndr 1993;6:820-822.

3. Prakash C, Coutinho A, Moller G. Inhibition of in vitro immune responses by a fraction from seminal plasma. Scand J Immunol 1976;5:77-85.

4. Hurtenbach U, Shearer GM. Germ cell-induced immune suppression in mice. J Exp Med 1982;155:1719-1728.

5. Dostal J, Veselsky L, Drahorad J, Jonakova V. Immunosuppressive effect induced by intraperitoneal and rectal administration of boar seminal immunosuppressive factor. Biol Reprod 1995;52:1209-14.

6. Okamoto M, Byrn R, Eyre RC, Mullen T, Church P, Kiessling AA. Seminal plasma induces programmed cell death in cultured peripheral blood mononuclear cells. AIDS Res Hum Retroviruses 2002;18:797-803.

7. Jason JM, McDougal JS, Dixon G, Lawrence DN, Kennedy MS, Hilgartner M, et al. HTLV-III/LAV Antibody and Immune Status of Household Contacts and Sexual Partners of Persons with Hemophilia. J Am Med Assoc 1986;255:212-215.

8. Kessler CM, Schulof RS, Goldstein AL, Naylor PH, Luban NL, Kelleher JF, et al. Abnormal T-Lymphocyte Subpopulations Associated with Transfusions of Blood-Derived Products. Lancet 1983;i:991-992.

9. Tsoukas C, Gervais F, Shuster J, Gold P, O'Shaughnessy M, Robert-Guroff M. Association of HTLV-III Antibodies and Cellular Immune Status of Hemophiliacs. N Engl J Med 1984;311:1514-1515.

10. Chandra RK, Gupta S, Singh H. Inducer and suppressor T cell subsets in protein-energy malnutrition: Analysis by monoclonal antibodies. Nutrition Research 1982;2:21-26.

11. Levy JA, Ziegler JL. Acquired immunodeficiency syndrome is an opportunistic infection and Kaposi's sarcoma results from secondary immune stimulation. Lancet 1983;ii(8341):78-81.

Competing interests: None declared