Hemophilia: Treatment

Factor Replacement Therapy Factor Therapy Complications Inhibitor Treatment

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Complications of Factor Replacement Therapy

Complications of replacement therapy include:

• Developing antibodies, which are proteins that act against the replacement clotting factor. This antibody response is called an “inhibitor.”
• Developing viral infections from human clotting factors

Delayed treatment of a bleed can result in damage to joints, muscles, or other parts of the body.

Antibodies to Clotting Factor

Antibodies destroy the clotting factor before it has a chance to work. This is a very serious problem, because it makes the main treatment for hemophilia — replacing clotting factor — no longer effective.
Antibodies to clotting factor develop in about 20 percent of people with severe hemophilia A and 1 percent of people with hemophilia B.

When antibodies develop, doctors may use larger doses of clotting factors or try different sources of clotting factor. Sometimes, the antibodies go away. Researchers are studying ways to deal with antibodies to clotting factors.

Viruses from Human Blood Factors

The viruses that cause AIDS (HIV) and hepatitis can be carried in clotting factors. However, there has been no documented case of these viruses being transmitted during replacement therapy for about a decade. Transmission of viruses has been prevented by:

• Careful screening of blood donors
• Testing of donated blood products
• Treating donated blood products with a detergent and heat to destroy viruses
• Vaccinating people with hemophilia for hepatitis A and B

Researchers continue to find ways to make blood products safer.