Hemophilia B Complications

Complications can occur in hemophilia B as a result of the condition itself or its treatment, such as factor replacement therapy.

Complications may include1,2:

  • Joint damage
  • Hepatitis
  • Development of inhibitors, which are antibodies to clotting factors

Joint damage

One of the major complications of hemophilia is joint damage, or hemophilic arthropathy, that can occur when there is bleeding into joints. This is the most common clinical complication of hemophilia. Bleeding into knees, elbows, ankles, shoulders, and hips can lead to chronic swelling, pain, immobility, and eventual joint deformity.1

Repeated bleeding into the same joint is referred to as a target joint. Target joints are highly likely to progress toward permanent damage.1


Patients with bleeding disorders should receive vaccines for hepatitis A and B. According to the National Hemophilia Foundation, there have been no reports of hepatitis C transmission through the use of factor therapies since 1997, thanks to improved donor screening and manufacturing methods.2

Symptoms of hepatitis can include fatigue, nausea, vomiting, joint aches, vague abdominal discomfort, jaundice, and weight loss.2


In rare instances, the immune system produces an antibody that inhibits the action of replacement blood products and prevents clot formation. This antibody is known as an inhibitor. The presence of an inhibitor makes the treatment of bleeding episodes more difficult. An inhibitor destroys the clotting factor before it has a chance to stop the bleeding.1

Only about 1% to 6% of patients with hemophilia B develop an inhibitor—far fewer than with hemophilia A.3

The risk of developing an inhibitor does not remain the same during the lifetime of a person with hemophilia. Most inhibitors are reported to develop during childhood, at an average age of 12 years.3

Read more about inhibitors


  1. Inhibitors and other complications. National Hemophilia Foundation website. https://www.hemophilia.org/Bleeding-Disorders/Inhibitors-Other-Complications. Accessed October 14, 2014.
  2. Riley L, Womack M. Hepatitis and hemophilia. In: Nurses’ Guide to Bleeding Disorders. New York, NY: National Hemophilia Foundation; 2012. https://www.hemophilia.org/sites/default/files/document/files/Nurses-Guide-Chapter-10-Hepatitis-and-Hemophilia.pdf. Accessed October 23, 2014.
  3. DiMichele DM. Inhibitors in Hemophilia: A Primer. 4th ed. Montreal, QC: World Federation of Hemophilia; 2008. http://www1.wfh.org/publication/files/pdf-1122.pdf. Accessed October 22, 2014.