Evolving infectious complications in patients with hemophilia

Infections encountered in patients with hemophilia are changing as a result of technologic advances in the treatment of the disease. Ln hemophiliacs with transfusion-associated HIV infection, acquired over a decade ago, worsening HIV immunosuppression is associated increasingly with septic arthritis, postoperative orthopedic infection, and progressive hepatitis-associated liver disease. Prophylaxis for HIV-negative hemophiliacs, by frequent administration of clotting factor concentrate via a central venous line, has led to a rise in the frequency of central-line infections. Intermediate-and low-purity clotting factor concentrates have been contaminated with non-lipid-enveloped viruses, which are not inactivated by the purification methods used in the manufacture of these products.