Is immune oversuppression the direct cause of AIDS?

AIDS is presumably caused by HIV, a retrovirus. The main support for this view comes from the consistent epidemiological correlation between AIDS and the presence of antibody against HIV. Several HIV-associated mechanisms have been described to explain the cytopathic effects on helper-T-lymphocytes observed in vitro but so far, none of these mechanisms has been confirmed in vivo. On the other hand, there is virtually no free virus and HIV RNA synthesis is very low both in AIDS patients and in asymptomatic carriers. Thus it is unlikely that HIV causes AIDS by acting as a conventional cytocidal virus. Here it is proposed, on the basis of current experimental evidence, that an active immune suppression mediated by T8+ cells is the direct culprit for a gradual decline of helper-T-lymphocyte numbers leading to an immunocompromised state in AIDS. The role of HIV in triggering and perpetuating a state of immune oversuppression is discussed.