Pipe Steven
Hemophilia and Coagulation Disorders Program, University of Michigan, Ann Arbor, MI 48109, USA.
Semin Hematol. 2006 Apr;43(2 Suppl 3):S23-7. doi: 10.1053/j.seminhematol.2006.02.002.
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.
在过去二十年中，通过开发有效且日益灵敏的病原体筛查和灭活方法，以及引入用于治疗血友病的重组凝血因子（始于1992年的重组因子VIII），经由凝血因子疗法传播病原体的风险已有所降低。然而，对于一种新兴传染病原体通过血液和血液制品传播可能性的新认识，再次引发了人们对血浆源性和某些在制造过程某些阶段仍使用血浆成分的重组凝血疗法中存在的漏洞的担忧。在20世纪80年代，血友病患者成为了血液供应中人类免疫缺陷病毒（HIV）和丙型肝炎病毒（HCV）的“煤矿中的金丝雀”。展望未来，医疗保健提供者必须继续积极主动地了解有关新兴病原体的新信息，并制定方法，在治疗选择过程中与患者讨论这种风险。
