hemophilia

Az is 14 years old malay boy, youngest of 5, father is RISDA officer, mother is house wife. Both parents are also hemophilia carriers.

currently come for prophylactic factor 8 infusion which is 3 times weekly.

he has few issues.
he is a hemophiliac, type 1 diagnosed at age 7 months, he started crawling and started having easy bruising mostly at knees. Actually there was a bruise at his left ear at birth but it resloved. He was diagnosed in HUSM as severe hemophilia A. At the age of 12 mnt he had prolonged bleeding from scratches at neck, so required admission and the first factor 8 infusion/ since then he requiresd admisssion 4-5 monthly for skin hematomas and factor 8 was given. he had 2 operations one for tooth extractions and the other for cicumcission; both were complicated with prolonged bleeding.
developed lt knee hemarthrosis, which was quite diffficult to control inspite of been given factor 8 daily for more than 2 weeks. inhibitors were negative. he required surgical drain this time ,

he is never been tried aith desmopressin, prothrombin complex concentrate
currently he is mobile tough the swelling has not completely resolved. able to go school by bicyclke.
he is still been followed up in the ward rather than been in clinic.
still he comes to the ward for infusion. since factors are not been released for administration at home, he has learned how to mix the factor to make solution but his parents still do not know how to access to iv line.
3. he is also hepatitis c positive. confirmed by ROBA but not on any treatment for tha.

he has no neurological deficit