Complications

Complications can occur in hemophilia B as a result of the condition itself or treatment, such as replacement therapy. Complications include the development of inhibitors, joint damage, HIV/AIDS and hepatitis.

Complications of replacement therapy

In some patients with hemophilia, the immune system produces an antibody that inhibits the action of replacement blood products and prevents clot formation. This antibody is known as an inhibitor. The presence of an inhibitor makes the treatment of bleeding episodes more difficult. An inhibitor destroys the clotting factor before it has a chance to stop the bleeding. Learn more about inhibitors.

Joint damage

One of the major complications of hemophilia is joint damage or “hemophilic arthropathy” that can occur when there is bleeding into joints. This is the most common clinical complication of hemophilia. Bleeding into knees, elbows, ankles, shoulders and hips can lead to chronic swelling and later joint deformity. Many people with severe hemophilia can suffer from painful, debilitating joint bleeds and associated mobility issues that can have a negative impact on quality of life.

HIV/AIDS

In the late 1970s and the 1980s, people with hemophilia were treated with blood products derived from thousands of donors. When the U.S. blood supply became contaminated by HIV, the products used as treatment for thousands of people with bleeding disorders also became contaminated. More than 50% of the hemophilia population became infected with HIV prior to 1985.

However, HIV transmission by factor concentrates in the United States has not occurred since 1986. This is mainly due to the development of viral inactivation methods that are now used in the manufacture of blood products. In addition, improved donor screening and product processing procedures are now in place, and improvements continue to be made.

Hepatitis

Hepatitis viruses were also transmitted in blood products used by persons with bleeding disorders. Today’s blood products are much safer than those of the past. Since 1997, there have been no new reports of hepatitis C transmission from the use of factor therapies. .

There are six main hepatitis viruses, but almost 95% of all cases involve hepatitis A, B or C. Symptoms of hepatitis include fatigue, nausea, vomiting, joint aches, liver tenderness and enlargement and weight loss.

Transmission of hepatitis A remains a risk for people with bleeding disorders who use plasma-derived products. This is because hepatitis A virus can resist the viral inactivation methods used to manufacture plasma products. Hepatitis A is preventable. The Medical and Scientific Advisory Council recommends that all patients with bleeding disorders receive a hepatitis A and B vaccination. Currently, there is no vaccination for hepatitis C.