Home treatment of haemophilia. A follow-up study

Twenty-four children and adolescents who have been receiving home treatment for haemophilia A and B, and were followed up for a median period of five years, have been assessed for physical activity, social adjustment, range of joint movement and infection with hepatitis viruses. They were treated with cryoprecipitate from 1972 to 1977, and since then with factor-VIII concentrates. The average dose of factor VIII was 20 units/kg body mass. It was found that there was near normal range of physical activity and school performance, and, in virtually all families, near normal family function could be preserved. Approximately one-third of the patients showed impairment of the normal range of joint movement in flexion and extension. Although there was no clinical evidence of liver disease, elevated aspartate aminotransferase (AST) levels were found in 14 patients. Evidence of past, or present, infection with hepatitis B was found in 19 patients, and of infection with hepatitis A in seven patients. Home treatment is associated with a reduced level of disability from haemophilia, but transfusion therapy continues to be associated with a high rate of liver function abnormalities, probably of infectious origin.