Both factor VIII and factor IX haemophilia can cause, by repeated bleeding into the joints, a progressive joint destruction. Risk of bleed is predicted by the factor levels in the patients - spontaneous bleeds occur if the patient has levels of 5% or less of the normal levels.
The frequency and unpredictability of the bleeds in a haemophiliac pose a considerable disruption to life, and these ought to be considered when considering the impact of this disease on people.
This can be classified as; (1)
High risk - if severe haemophilia and not receiving prophylactic therapy (defined as the regular, continuous administration of a haemostatic agent/agents with the goal of preventing bleeding in people with haemophilia while allowing them to lead active lives and achieve quality of life comparable to non-haemophilia individuals).
Medium risk - if moderate haemophilia and not receiving prophylactic therapy.
Low risk - if mild haemophilia.
These complications may be prevented by the use of prophylactic factor VIII or factor IX infusions, or emicizumab for haemophilia A. (2)
Reference
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