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January 20, 1984

Cause of Acquired Immune Deficiency Syndrome

Author Affiliations

Harlem Hospital Center College of Physicians and Surgeons Columbia University New York

JAMA. 1984;251(3):342. doi:10.1001/jama.1984.03340270023016

To the Editor.—  A recent issue contains a hypothesis of etiologic factors in pathogenesis of AIDS, the widely publicized condition affecting chiefly homosexual men, that is fascinating but not entirely new. In 1982, two of us (C.N. and J.W.C.H.) proposed a similar hypothesis1 emphasizing, however, the immunosuppressive effects of human seminal plasma rather than sperm alone. The prostaglandins and polyamines present in semen are held responsible for this immunosuppressive capacity. Furthermore, prostaglandins have been implicated as factors inducing tumors, including skin tumors.1 Prostaglandins should then be taken into account in the investigation of agents leading to AIDS, both as immunosuppressors and as possible inducers of Kaposi's sarcoma in male homosexuals.We also postulated the possible transfer of allogeneic lymphocytes through the rectal mucosa and pointed out the similarity of AIDS to chronic graft-v-host disease (GVHD), particularly with a subset of patients who have increased activity of suppressor