In the mildest forms, however, usually there is not much inconvenience from spontaneous bleeding, and the diagnosis is often made much later in life, in many cases only when the patient is found to have an increased bleeding tendency in connection with surgery or tooth extraction. Care of haemophilia patients is centralised to highly specialised haemophilia centres. Patients with severe and moderate forms are checked up twice yearly during childhood and thereafter usually once a year. Those with the mild form are checked up every 3-5 years. Most patients with severe or moderate haemophilia receive prophylactic treatment with factor concentrate in order to reduce the bleeding tendency.
Most patients still get bleedings that require extra treatment now and then.
If the bleeding or intervention is of a minor nature, mild forms of haemophilia A can sometimes be treated with desmopressin, since this substance increases factor VIII activity in the blood. Patients who do not respond properly to desmopressin should be treated with coagulation factor concentrates. Patients who do not respond properly to desmopressin should be treated with coagulation factor concentrates. Dextran should also be avoided and intramuscular injections are contraindicated. Since it is very likely that the patients sooner or later will require treatment with purified plasma products, vaccination against hepatitis A and B is recommended.