Consideration in hemophilia therapy selection.

The risk of pathogen transmission via clotting factor therapies has been reduced over the last two decades through the development of effective and progressively more sensitive pathogen screening and inactivation methods and the introduction of recombinant clotting factors for hemophilia, beginning with recombinant factor VIII (FVIII) in 1992. However, new understanding about the potential for transmission of an emerging infectious agent through blood and blood products has renewed concerns about vulnerabilities that remain in plasma-derived and some recombinant clotting therapies that still use plasma components during some stages of the manufacturing process. In the 1980s, patients with hemophilia became "canaries in the coal mine" for human immunodeficiency virus (HIV) and hepatitis C virus (HCV) in the blood supply. Moving forward, healthcare providers must continue to take a proactive role in educating themselves about new information regarding emerging pathogens and develop approaches to discussing this risk with their patients as part of their therapy selection process.