1. AIDS in drug users and homosexuals in the USA and Europe is probably caused by the heavy ancillary use of glucocorticoids and other immunosuppressive agents to medically treat the wide range of the chronic serious illnesses.
2. AIDS in hemophiliacs is clearly related to the use of corticosteroids and other immunosuppressive agents to prevent the development of antibodies for factors VIII and IX and to treat chronic illnesses.
3. AIDS in people receiving blood and/or tissue is related to the use of glucocorticoids to prevent reactions of transfusion and tissue rejection.
4. AIDS in infants and children is probably caused by their exposure to drugs and corticosteroids in utero and their exposure to corticosteroids after birth used to treat their chronic illnesses.
5. AIDS in Africa is caused  by malnutrition, release of endogenous cortisol, and by opportunistic diseases. Atrophy in the lymphoid tissue has been observed in HIV-negative people suffering from malnutrition.
6. Damage to the immune system is rapidly reversible after removal of the true insulting agent or treatment of the true causes in both HIV-positive and HIV-negative AIDS patients.
7. Kaposi’s sarcoma (KS) and lymphoma are probably induced by the use of steroids and drugs, and the release of endogenous cortisol.  8) HIV appears to be a harmless virus both  in the in vivo and  the in vitro settings.
8. The uses of glucocorticoids, AZT, and protease inhibitors to treat AIDS are contraindicated.

Key words: HIV, AIDS, drugs, corticosteroids, malnutrition, hemophilia, blood transfusion, lymphoid atrophy.

The following case history was the spark that ignited this in-depth investigation of the causes and pathogenesis of acquired immune deficiency syndrome (AIDS). A 60 year-old-white male, HIV-negative, developed Acquired Immune Deficiency Syndrome (AIDS) following treatment with a two month course of prednisone (60 mg per day) and a two week course of azathioprine (50-100 mg per day) for lung fibrosis. His blood CD4 + T cells count was 255/uL the CD4 + T cells /CD8 + T cells ratio was 0.6, and he had severe lymphocytopenia. He also suffered from pneumonia and severe fungal infection in his mouth and skin. Cessation of the treatment with prednisone and azathioprine lead to the reversal of the damage in his immune system. He fully recovered from pneumonia and the fungal infection after a short course of antibiotics and the use of antifungal lotion. Twenty two days after the last dose of prednisone, his CD4  + T cells count was back to normal at 657 cells/uL (Al-Bayati, 1999)

Review  of the literature of the causes and the pathogenesis of AIDS worldwide revealed  that approximately 90%  of AIDS cases in the USA and Europe are observed  in homosexual men and drug users.  The regular  uses of alcohol, heroin, cocaine, amphetamines, and alkyl nitrite cause chronic health problems of the nervous system, respiratory system, cardiovascular system, kidneys and other tissues in these individuals.  The majority of these health problems are usually diagnosed as idiopathic currently, and treated with  high doses of glucocorticoids and/or cytotoxic drugs. In addition, homosexual men are usually heavy user of illicit drugs, alcohol, and rectal glucocorticoids ( Fauci et al., 1998;  Al-Bayati, 1999).

The HIV-hypothesis states that HIV causes AIDS by killing the CD4+ T cells directly or indirectly after long incubation times (about 10 years),  and the number of these cells will reach very low levels (<300/ml) which lead  to severe immune deficiency. Patients with severe immune deficiency (CD4+ T cells < 200/µL) usually suffer from opportunistic infections (viral, bacterial, fungal, yeast, and/or parasitic) and certain form of cancer such Kaposi’s sarcoma and lymphoma. It follows that treatment of patients with antiviral drugs such as inhibitors of reverse transcriptase (AZT) or  protease  is believed to delay the progression of AIDS by preventing HIV replication in the cells (Gallo, 1987;  Fauci et al., 1998 ).

However, the treatment of a patient with prednisone at 60 mg per day for about three months can actually cause AIDS as described above. This treatment and doses often given to patients suffering from lung fibrosis, thrombocytopenia, or other chemically induced chronic illnesses. For example, Fauci et al., 1998 (p. 1463) described the treatment for  patient with lung fibrosis   as follows: “A trial of oral prednisone is begun at a dose of 1 mg/kg daily and continued for about 8 weeks. Should the disease not respond or be progressive, additional immunosuppression with cyclophosphomide should be considered. The objective is to reduce the white blood cell count to approximately half the normal baseline value, causing a distinct drop in the total lymphocyte count. However, a minimum count of 1000 PMNs/ul should be maintained”. At this dose levels, the CD4+T cells count in the peripheral blood of  the treated individual is expected to be <300/ul which meets the definition for AIDS set by the US Center For Diseases Control and Prevention (CDC).

Further investigation also revealed an astonishing result: the majority of AIDS patients who participated in the four major Zidovudine (AZT) clinical trials in the US between 1987-1992 were HIV-negative prior to their treatment with AZT. Briefly, a total of 2,349 patients participated in these studies, and at least 77%  of them were HIV-negative prior to their treatment with AZT.  HIV status of participants upon entrance to these studies are: a) Fischl et al., 1987: 282 patients participated; HIV was isolated at entry from 160 patients (57 percent of the AZT group and 58 percent of the placebo group); b) Fischl et al., 1990: 406 AIDS patients were treated with AZT but only 50 percent of these subjects had detectable serum levels of HIV antigen before treatment; c) Volberding et al., 1990: 1338 subjects participated; only 117 patients (9%) had detectable levels of  HIV p24 antigen at baseline; and d) Hamilton et al., 1992: 321 AIDS patients received AZT but only 63 patients (20%) had  detectable level of p24 antigen at base-line.

The reversal of  CD4+ T cells depletion in the peripheral blood was  reported in HIV+ homosexual men after the termination of their treatment with glucocorticoids. Sharpstone et al., 1996 reported that eight HIV+ males with inflammatory bowel disease who used rectal steroid preparation had a decline in  their CD4+ T cells at a rate of 85 cells/µL per year. Four of them underwent coloectomy that eliminated the need for the steroid and their CD4+ T cells increased 4 cells/µL  per year.  Eight case-matched controls who did not have surgery continued to have a decline of 47 cells/µL per year as the result of the use of rectal steroid.

Furthermore, the reversal of the reduction in CD4+T cell count in HIV+ pregnant women following proper feeding was also reported by Fawzi et al., 1998. Briefly, the influence of diet on T cells counts in peripheral blood in 1,075 HIV-infected pregnant women who had poor nutritional status were studied.The CD4+ T cell counts of the women who  received multivitamin increased from 424/µL to 596/µL  during six months of proper feeding.

The reversal of damage in the immune system in HIV-positive patients following the cessation of the insulting agents and the existence of large number of HIV-negative AIDS patients as described above, combined with the wide use of immunosuppressive agents in modern medicinal practice to treat a variety of  drug induced chronic illnesses  gave me the incentive to review the medical literature to evaluate the validity of  the HIV-hypothesis and the contribution of  the illicit drugs, alcohol, and therapeutic agents, and malnutrition  to the pathogenesis of AIDS worldwide.

Methods The correct approach for solving AIDS causes or pathogenesis questions or any other complicated chronic medical problems is by evaluating all medical evidence concerning each risk group. Namely, a differential diagnosis that considers both  infectious and noninfectious causes of  diseased should be performed.  To test the validity of  the HIV-hypothesis,  I reviewed the medical literature to evaluate the role of drugs, malnutrition, and infectious agents in the pathogenesis of AIDS worldwide. Detailed descriptions of the studies that I reviewed to evaluate  the validity of the HIV-hypothesis were reported. The results indicate that the medical evidence  show AIDS is probably caused by the use of illicit drugs, therapeutic use of corticosteroids, and malnutrition. Differential diagnosis indicated that HIV is not involved.

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