Table 3. Choice of Concentrate: High or low-purity; Recombinant or plasma-derived?*

Recombinant factor products are recommended for:

  • All previously untreated patients
  • Patients who have been treated but remain HCV and HIV seronegative
  • Mild and moderate severity disease when desmopressin is not sufficient (e.g., surgery or trauma)

Plasma-derived products are recommended for:

  • HCV-and HIV-seropositive individuals

High-purity products are recommended for:

  • Surgical procedures (to avoid the thrombogenic side effects of less pure factor IX products and to facilitate continuous infusions)
  • Immune tolerance induction and prophylaxis regimens
  • HIV-seropositive individuals with CD4 counts > 200/mm3 (increased purity may preserve CD4 lymphocyte levels)

Abbreviations: HIV=human immunodeficiency virus; HCV=hepatitis C virus

* Reference: Lozier JN, Kessler CM. In: Hoffman R, et al, editor. Hematology: Basic Principles and Practice 3rd ed. New York: Churchill Livingstone p. 1883-1904.

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