Document 1133
 DOCN  M9591133
 TI    Haemophilia A management in Victorian, New South Wales and South
       Australian haemophilia centres.
 DT    9509
 AU    Ekert H; Ekert NL; Street AM; Rickard KA; McPherson VJ; Toogood IR;
       Lloyd JV; Royal Children's Hospital, Melbourne, VIC.
 SO    Med J Aust. 1995 Jun 5;162(11):569-71. Unique Identifier : AIDSLINE
       MED/95311770
 AB    OBJECTIVE: To examine the management of haemophilia A in Australia and
       to compare it with international trends. METHODS: Six haemophilia
       centres treating most patients in Victoria, New South Wales and South
       Australia were surveyed in 1993 by means of a written questionnaire
       followed by an on site interview. RESULTS: The centres were treating 739
       patients; 234 (32%) had severe haemophilia. Factor VIII inhibitors were
       present in 5.9% of all patients and in 19% of those with severe disease.
       Twenty-three per cent were human immunodeficiency virus (HIV)
       antibody-positive and 74% were hepatitis C virus (HCV)
       antibody-positive. The main treatment was on demand therapy for acute
       bleeds (average use of factor VIII: 1350 IU/kg per year for children;
       and 780 IU/kg per year for adults). Prophylactic therapy was used in
       only 17 patients, with doses of 3000-4500 IU/kg per year. One million IU
       was used for three patients with high titre inhibitors who had
       tolerising therapy. While most developed countries have a factor VIII
       supply of 2-5 IU per capita, the total supplied to the States
       represented 1.46 IU per capita, while use at the centres represented 1.1
       IU per capita. CONCLUSION: Because supply of factor VIII is limited, use
       was less than half that recommended internationally. Shortage of factor
       VIII has compromised prophylactic therapy and virtually prevented
       tolerising therapy.
 DE    Acute Disease  Adolescence  Adult  Child  Comparative Study  Drug
       Tolerance  Factor VIII/ANTAGONISTS & INHIB/ANALYSIS/SUPPLY &
       DISTRIBUTION/  THERAPEUTIC USE  Hemarthrosis/DRUG THERAPY/PREVENTION &
       CONTROL  Hemophilia/BLOOD/DRUG THERAPY/PREVENTION & CONTROL/*THERAPY
       Hemorrhage/DRUG THERAPY/PREVENTION & CONTROL  Hepatitis
       Antibodies/ANALYSIS  Hepatitis C Viruses/IMMUNOLOGY  Home Infusion
       Therapy  Human  HIV Seropositivity/BLOOD  New South Wales
       Questionnaires  South Australia  Support, Non-U.S. Gov't  Victoria
       JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
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