The treatment of hemophilia, since 1985, consisted in the infusion of a concentrated of the missing or lacking coagulation factor, extracted by the blood of a number of donors. This was done without viral inactivation of the treatment thus obtained. As consequence of that, a number of hemophiliacs were infected by hepatitis C (HCV) and acquired immune deficiency syndrome (HIV). From 1985, viral inactivation through heat of these blood derived treatments was introduced, and after that not a case of viral infection with HIV or HCV was registered in hemophiliacs.
Today, thanks to the antiretroviral drugs, the quality and the life expectancy of hemophiliacs suffering HIV are similar to HIV negative patients. This improvement permits, also, to the HIV-discordant couples (male hemophiliac patient with HIV and HIV-negative partner) to have a baby without exposing the woman and the child to the risk of infection.
The procedure is fairly simple and consists of a filtering process performed on the sperm and the subsequent elimination of HIV-infected cells. Then, through a sperm washing procedure it is possible to eliminate the residual virus present in the seminal plasma. This processing technique is called "sperm washing". Once the absence of contamination is verified, the spermatozoids can be used for intrauterine artificial insemination or extra-corporeal fecundation.
In our center, it would be possible to set up a support service for the couples HIV-discordant who want to have a child and that come from different Italian Centers of Hemophilia. This can be done through a monthly consulting session with all the necessary staff. During these sessions, the hematologist (Prof. Peyvandi) and the gynecologist (Dr Semprini) will illustrate the topics related to the procedures of a possible artificial fecundation. The set up of a service of assistance to patients affected by hemophilia that wish to enjoy the benefits of artificial fecundation can then be implemented with to the collaboration with AICE and the Paracelso Foundation.