In addition to bleeding, people with hemophilia must be on the watch for a number of health complications. Medications must be controlled carefully; taking aspirin, NSAIDs and other blood-thinning drugs can lead to serious consequences. Dental hygiene must be carefully maintained. Finally, hemophilia patients who require transfusions of blood products are at increased risk of contracting viruses from infected plasma, although this is less of a problem today than it was in the past.
Hepatitis C and HIV
During the 1980s, hemophilia was treated by replacing low levels of clotting factors with blood plasma pooled from thousands of donors. This strategy, although an effective treatment for hemophilia, proved to have serious safety issues. Viral agents, especially hepatitis C and HIV, were passed on to people with hemophilia through the pooled plasma. By the time the health risk was discovered, almost seventy percent of people treated with pooled plasma had contracted HIV.
The infection rate for hepatitis C was even higher: almost 100 percent of people treated with pooled plasma for hemophilia were infected with hepatitis C in the 1980s. More information about the symptoms and health risks associated with hepatitis C can be found at the About Hepatitis C web site.
New viral inactivation systems have made pooled plasma a much safer treatment for hemophilia than it was in the 1980s. The addition of new recombinant treatments for hemophilia has further lowered the chances of contracting HIV and hepatitis C infections, as recombinant treatments carry no risk of viral transmission.
Hemophilia, Hepatitis C and the Liver
Hemophilia patients infected with hepatitis C have a greater than average chance of developing cirrhosis of the liver and liver cancer. In fact, infection with hepatitis C causes a thirty-fold increase in the risk of liver cirrhosis. Liver cirrhosis and hepatitis C have both been linked to a higher risk of developing liver cancer. More information about the relationship between hepatitis C and liver cirrhosis can be found at the web site Learn about Cirrhosis.
Kaposi’s Sarcoma and Non-Hodgkin’s Lymphoma
Many hemophilia patients have also acquired HIV through infected blood products. Infection with HIV increases the risk of a number of possible health complications. People living with hemophilia and HIV are more at risk for Kaposi’s sarcoma (a cancer that affects the blood vessels and connective tissue) and non-Hodgkin’s lymphoma.
NSAIDs, Aspirin, and Blood-Thinning Medications
Hemophilia patients must clear any medication use with their doctors, including nonprescription painkillers. Common painkillers, such as aspirin and NSAIDs (nonsteroidal anti-inflammatory drugs) thin the blood, making blood clotting more difficult. Common NSAIDs and blood-thinning painkillers include aspirin, ibuprofen, naproxen and ketoprofen. NSAIDs and aspirin come in many different forms: it is important to check with a physician before taking any form of medication.
In addition to NSAIDs and aspirin, hemophilia patients should avoid other medications specifically designed to thin the blood. A number of such medications exist: heparin and warfarin are the most common.
Proper dental hygiene is essential for hemophilia patients. Regular brushing, flossing, and other dental hygiene habits lower the need for tooth extractions or other dental surgery. Dental surgery increases the chances of excessive bleeding, including bleeding at the base of the tongue, a life-threatening condition that causes the airway to constrict. Dental hygiene tips include brushing after every meal, flossing, and attending regular dental check-ups.
Chronic Joint Bleeding
Severe hemophilia can cause spontaneous bleeding into the joints and muscles, sometimes as frequently as twice a week. Joint and muscle bleeding causes intense pain and can lead to loss of joint function. Swollen limbs may feel either numb or painful if the swelling presses on local nerves.
Without treatment, chronic joint bleeding can permanently damage joint cartilage and surrounding bone, crippling the joint and causing physical deformity. Uncontrolled hemorrhage can be fatal.
Even minor head trauma can cause intracranial bleeding (bleeding inside the skull) in severe cases of hemophilia. Intracranial bleeding is a leading cause of hemophilia-related death, and requires emergency medical attention.