1980s-90s: Contamination from Blood-Derived Products
When factor products made from donated blood were first introduced in the 1960s, the treatment of hemophilia was revolutionized. Almost overnight, rather than requiring hospitalization for bleeds, a bleed could be treated at home by the patient/family. The pain associated with bleeding was greatly reduced, and many patients were able to lead a greatly improved quality of life.
Unfortunately, by the early 1980s, it was discovered that these blood-derived products were contaminated with infectious viruses such as hepatitis and HIV, and over the next decade, thousands of people with hemophilia died or became infected.
Although many of those who received contaminated factor product during the 1980s succumbed to their illnesses, not all did. Today, those survivors may still have these co-existing illnesses such as hepatitis or HIV.
By the late 1980s and early 1990s, improved blood donor screening, product testing, and purification techniques largely removed the risk of viruses being transmitted in blood-derived products. Today with the wide availability of recombinant products and products made from US-sourced blood undergoing multiple rounds of purification and testing, the risk of factor transmitting any virus is very low.
Food-Borne vs Blood-Borne Cases of Hepatitis
Hepatitis is a disease of the liver. There are many types of hepatitis; the most common being hepatitis A (HAV), B (HBV) and C (HCV).
Hepatitis A is most commonly the result of eating contaminated food. Hepatitis B and hepatitis C are blood borne and passed from one person to another through bodily fluids. There are vaccinations available for hepatitis A and B.
The staff at IHTC will discuss vaccinations during your clinic visit and make recommendations if they are needed. With the introduction of recombinant products and advanced techniques to test and remove hepatitis B and C from the US blood supply, it is unlikely that anyone with hemophilia will develop hepatitis today from administering US-sourced factor product.
Although US-sourced factor product can be considered safe (as can product from other major industrialized nations), greater caution should be exercised in countries with more limited medical resources.
Prior to the 1990s, most patients with hemophilia who used clotting factor made from donated blood were infected with one or more types of hepatitis. Along with the risk of developing HIV from contaminated factor products, this was one of the worst large-scale tragedies to affect those with hemophilia.
Hepatitis C, if untreated, can lead to cirrhosis and liver cancer. In the past, treatment for hepatitis C was lengthy (up to a year) and had unpleasant side effects. Today, there are highly effective treatments (known as antivirals) to cure hepatitis C within 12 weeks.
At the IHTC, we can provide support and counseling related to hepatitis. IHTC also coordinates the care of those with hepatitis with a liver specialist also called a hepatologist.
Post-Epidemic Advancements in Treatment and Product
During the AIDS epidemic in the US in the 1980s, the US blood supply became contaminated with the HIV virus from infected blood donors. During this period, the only products that were available to treat hemophilia were made from donated blood, and thus many people with hemophilia became infected with HIV.
It is estimated that about 50% of all those with hemophilia became infected, including around 90% of those with severe hemophilia. Thousands of people with hemophilia developed AIDS and died from this disease. Many others from that era still live with HIV today.
In 1985, the US began screening donated blood for the HIV virus, and over the next several years, increasingly advanced and sensitive tests were introduced. Virus-killing techniques were introduced in 1987 to further increase the safety of products made from donated blood, , which have also been refined and improved over the years.
Since 1987, there have been no incidences of HIV being transmitted from a US-sourced factor VIII or factor IX product. Today, the US blood supply and products made from it are considered some of the safest in the world.
Although there isn’t a cure for HIV, highly effective treatments are available to prevent the progression of the disease. Many members of the IHTC staff treated patients during the AIDS epidemic and saw firsthand how HIV affected the lives of people with hemophilia and their families.
Today we continue to stand by those who are affected by HIV. As HIV treatment is very specialized, we coordinate your HIV treatment with an infectious disease specialist. Your best care is our priority at IHTC.