Ozone is a highly unstable form of oxygen with disinfecting properties. Test tube studies suggest that it can damage viral particles and inhibit HIV's reverse transcriptase enzyme. Two research teams reported that in laboratory studies it inactivates HIV at concentrations which are non-toxic to human cells, but another team found that levels of ozone needed to kill animal viruses also resulted in 30% destruction of blood cells and haemoglobin.

Current use

Ozone is an unlicensed, experimental treatment. Despite the promising test-tube results, there is no clear evidence that ozone is a beneficial treatment for people with HIV. Two phase I studies showed no clear-cut effects on CD4 count or virus levels, and a phase II study showed no difference between the effects of ozone or placebo on a range of immunological and clinical measures.

Ozone has been promoted by individuals in several countries who charge large fees for treatment, despite the lack of evidence of efficacy. Claims have been made that people have been `cured' through ozone treatment, but no `cured' person has ever been produced for verification. There have also been reports of several deaths as a direct result of intravenous ozone infusions. Most AIDS specialists and groups for people with HIV advise extreme caution in the use of this treatment.

Taking it

Ozone can be administered in several different ways. Blood can be removed from the individual, exposed to ozone and then reinfused. Alternatively, a machine can be used which generates ozone gas and delivers it into the rectum, where it is thought to be absorbed through the mucous membranes. The most dangerous method consists of injecting ozone gas directly into the bloodstream. Hydrogen peroxide injections are also sometimes used as part of, or independently of, ozone therapy. Advocates of hydrogen peroxide also recommend drinking or bathing in it. However, doctors have reported one case in which a man with AIDS died after injecting himself with 35% hydrogen peroxide.

Key research

Wells reported that the antiviral effects of ozone include viral particle disruption, reverse transcriptase inactivation and/or a perturbation of the ability of the virus to bind to its receptor on target cells. Freeberg and Carpendale (1991) reported that ozone inactivated HIV at non-toxic concentrations, but Wagner found that at concentrations required to inhibit animal viruses, ozone induced 30 percent haemolysis and destruction of extracellular haemoglobin.

Bocci theorised that ozone induces the production of cytokines such as tumour necrosis factor (TNF) and interferon.

Carpendale (1993) reported that 4/5 HIV-positive men with diarrhoea of unknown origin improved when treated with ozone. However, the responders all had relatively high CD4 counts, and diarrhoea can resolve spontaneously, particularly at higher CD4 counts.

Garber performed a phase I study of ozone blood treatments in 10 HIV-positive individuals. No significant toxicity was observed. Three participants with moderate immunodeficiency showed improvement in surrogate markers. In a phase II controlled and randomized double-blinded study comparing reinjection of ozone-treated blood and reinjection of unprocessed blood for 8 weeks, followed by a 4-week observation period, ozone had no significant effect on haematologic, biochemical or clinical toxicity when compared with placebo. CD4 cell count, interleukin-2, interferon gamma, beta₂-microglobulin, neopterin and p24 antigen were also unaffected by both treatment arms.

Hooker conducted an open study of ozone-treated blood in the treatment of 9 HIV-positive individuals. No significant change in mean absolute (or percentage) CD4 count was seen after 4 or 8 weeks of treatment. The HIV p24 antigen titre did not change significantly during treatment. One participant became weakly p24-antigenaemic during treatment, while another who was weakly antigenaemic at baseline became equivocal during therapy. The treatment was well tolerated; there was no bruising or local pain after the intramuscular injections.

Hirschtick reported the case of an individual who died after injecting himself with hydrogen peroxide.

Mayer reported the development of paranoid hallucinatory psychoses in a person receiving ozone therapy.

References

Bocci V. Ozonization of blood for the therapy of viral diseases and immunodeficiencies. Medical Hypotheses 39:30-34, 1992.

Carpendale MT et al. Ozone inactivates HIV at noncytotoxic concentrations. Antiviral Research 16(3):281-292, 1991.

Carpendale MT et al. Does ozone alleviate AIDS diarrhea? J Clin Gastroenterol 17(2):142-145, 1993.

Freeberg JK et al. Ozone inactivates extracellular human immunodeficiency virus at non-toxic concentrations. Fourth Intl Conf AIDS, Stockholm, abstract 3560, 1988.

Garber GE et al. The use of ozone-treated blood in the therapy of HIV infection and immune disease: a pilot study of safety and efficacy. AIDS 5:981-984, 1991.

Hirschtick RE et al. Death from an unconventional therapy for AIDS (letter). Ann Int Med 120(8):694, 1994.

Hooker MH et al. Ozone-treated blood in the treatment of HIV infection. AIDS 6:127-138, 1992.

Mayer C et al. Paranoid hallucinatory psychoses in an HIV infected patient on ozone therapy. Nervenarzt 62(3):194-197, 1991.

Wagner SJ et al. Virucidal levels of ozone induce hemolysis and hemoglobin degradation. Transfusion 31(8):748-751, 1991.

Wells KH et al. Inactivation of human immunodeficiency virus type 1 by ozone in vitro. Blood 78(7):1882-1890, 1991.