On November 28, 2005 clinicians, politicians and advocacy groups in the United Kingdom (UK) gathered to discuss the issue of emerging blood-borne pathogens. The one-day meeting focused on the potential risk these pathogens pose to the blood supply and to plasma-derived blood products used to treat bleeding disorders such as hemophilia. These public health issues were brought to the attention of the National Health Service (NHS), which provides healthcare for all UK citizens and sets overall policy on health issues.
Representatives from the National Patient Safety Agency, the Healthcare Standards Unit and other groups, met to assess the possible spread of infectious diseases such as variant Creutzfeldt-Jakob disease (vCJD). vCJD is an untreatable, prion-related disease resulting in very serious neurological symptoms and death. Since 1996, 158 people from Great Britain have been diagnosed with vCJD. Although these infections have been attributed to the consumption of meat from animals known to have mad cow disease, there also exists some evidence to suggest the potential of cross-infection through blood.
The spreading of lethal blood-borne diseases is not without precedent and is of specific concern to the hemophilia community. In the 1980s thousands of people with hemophilia were infected worldwide with hepatitis C and HIV through the use contaminated blood products and many have died. Chris Hodgson is the co-chair of the Haemophilia Alliance in the UK. “The threat of HIV and hepatitis C was written off at the time as ‘theoretical’ and the situation unfolded before our eyes,” said Hodgson. He added, “the outcome was devastating with around a third of those with haemophilia contracting HIV and virtually all of them also having hepatitis C.” For this reason Hodgson and others are advocating for continued access to recombinant factor products. Recombinant products, unlike human-derived factor, which is pooled from the plasma of many donors, is manufactured through genetic engineering for greater safety and efficacy. The UK government created the “Recombinant for All” program to ensure that hemophilia patients would have access to safer treatments. Because the program is set to expire at the end of 2006 and future funding is an uncertainty, the UK’s medical professionals and patient advocates are reminding the NHS of its importance.
“The risk of allowing people with haemophilia to continue to receive plasma products which may have been exposed to vCJD and to allow the haemophilia community to continue to be exposed to such uncertainty has a psychological effect, not only on the patient but on their families,” stated Hodgson. Plasma-derived products are now safer with added viral inactivation methods such heat and solvent detergent treatments as part of the manufacturing process. Although these products are still in use in the U.S., UK and elsewhere, the National Hemophilia Foundation’s Medical and Scientific Advisory Council (MASAC) recommends recombinant factor VIII and IX for the treatment of hemophilia A and B. To view MASAC Recommendations Concerning the Treatment of Hemophilia and Other Bleeding Disorders go to www.hemophilia.org/NHFWeb/MainPgs/MainNHF.aspx?menuid=57&contentid=433.
Source: Medical News Today (United Kingdom), November 29, 2005