Person with Hemophilia & HIV
Human Immunodeficiency Virus infection (HIV) is a viral infection that progressively destroys a certain type of white blood cell (lymphocyte) and causes Acquired Immunodeficiency Syndrome (AIDS).
Infection by the human immunodeficiency virus eventually results in progressive deterioration of the body's immune system, allowing opportunistic infections and certain cancers to develop. AIDS is the late stage of HIV infection.
Many persons with hemophilia are infected with HIV in India. This is because such people receive blood transfusions instead of the standard therapy with Anti Hemophilia Factor Concentrates.
Nowhere in the world, treatment with FFP or Cryo is advised for a person having hemophilia except a few developing countries. In such countries the prevalence rate of HIV is high as frequent transfusion of substandard blood components like FFP & Cryo are still practiced. The World Federation of Hemophilia, as a policy advocates for high quality Factor Concentrates as a standard treatment of hemophilia. Many countries have shifted to Recombinant Factors which are free from any viral contamination.
The AIDS epidemic has placed great health, economic, ethical and emotional burdens on such affected families and the wider bleeding disorders community. No case of HIV/AIDS has been found in people who have been using only Factor Concentrates since 1986 due to viral inactivation/removal (viral killing) methods that are adopted for producing Factors to treat such people. These viral inactivation processes include heat treatment, solvent-detergent cleansing, high specific gravities and Monoclonal purification.
The latest therapy to treat hemophilia is Recombinant Factors which are free from any risk of blood contamination but are prohibitively expensive for people in developing countries.
In order to prevent any HIV/AIDS infection in people with hemophilia Factor Concentrates are the treatment of the day and if Recombinant the better. This is the reason that this medicine has been placed in the List of Essential Drugs by WHO and Govt. of India.
All people suffering from hemophilia should be treated by high quality Factor Concentrates only as a rule. The transmission of HIV requires contact with a body fluid that contains infected cells or virus particles, including blood, semen, vaginal secretions, cerebrospinal fluid and breast milk. HIV is also present in tears, urine and saliva, but in much lower concentrations. The virus is transmitted in the following ways:
- Injection or infusion of contaminated blood, as occurs with blood transfusions, the sharing of needles or an accidental prick from an HIV-contaminated needle.
- Sexual relations with an infected person, during which the mucous membrane lining the mouth, vagina or rectum is exposed to contaminated body fluids.
Prevention
- People should abstain from sex with unknown and infected persons or engage only in safe (protected) sex.
- HIV-positive people should abstain from sex or have safe (protected) sex; they should not give blood or donate organs, avoid pregnancy and notify previous and prospective sexual partners.
- Drug abusers should halt the practice of sharing or reusing needles and enter a drug treatment program.
- Medical and dental professionals should wear latex gloves whenever there is a possibility of contact with body fluids, and properly use and dispose of hollow needles.
There is no current vaccination for HIV, but several new studies hold promise for the future.
Treatment
Many drugs are now available to treat HIV infection. All prevent the virus from reproducing and slow the progression of the disease. The trouble is HIV usually develops resistance to these drugs when they are used alone.
Treatment seems to be most effective when at least two to three of the drugs are given in combination. Drug combinations may delay the onset of AIDS in HIV-positive people and extend one's life compared with the use of single drugs. Recent studies suggest that these drug combinations can reduce the virus to undetectable levels and restore the immune system to near normal. Doctors aren't certain how soon after infection these drugs should be started, but people with high levels of HIV in their blood should be treated.
People with AIDS are usually prescribed drugs to prevent infections, such as pneumonia, as well.
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