• Recombinant products are treatment of choice. Second generation recombinants do not contain any human material in product. Human

354 donor-derived products are now subjected to double viral inactivation (solvent-detergent and heat treatment, e.g. 80°C for 72h); good record of viral safety.

- High and intermediate purity human donor-derived products available for patients not receiving recombinant therapy. No particular advantage for high purity over intermediate except possibly useful in patients with allergic reactions to intermediate purity.

High purity previously recommended for HIV +ve patients.

- Principle of treatment: raise factor VIII to haemostatic level (15-50u/dL for spontaneous bleeds, 40u/dL minor ops; 100u/dL major surgery or life-threatening bleeds).

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