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The AIDS Advisory document recorded that heat-treated commercial factor products were available. On the subject, Professor Bloom stated that during the early 1980s, several observers noted that there appeared to be a reduced risk of HIV infection and/or immunological abnormalities in patients with haemophilia B compared to those with haemophilia A.

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Following the fifth meeting by the AIDS Group, on 17 June 1985, more centres had transitioned to using commercial heat-treated Factor 9.

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Professor Bloom held, that around 1983-1984, that it was not necessary to inform patients or the parents of patients of the risks of AIDS.

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Professor Bloom held that he existence of the viruses causing serum hepatitis was well known to doctors caring for haemophiliacs during the 1960's, 1970's and later.

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The reference centre at the Manchester Royal Infirmary was part of a regional haemophilia service in North West England, which included Manchester Children's Hospital and the Lancaster Haemophilia Centre.

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Most patients being treated for haemophilia who were treated at the Manchester Royal Infirmary would have been informed that there was a high likelihood of them having AIDS. They were informed either by letter or through routine appointments.

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One of the aims of the appointment of Dr Wensley was to create a better understanding with the RTC and "a greater availability of cryoprecipitate and better treatment for all
haemophiliacs."

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Manchester Royal Infirmary's role was described in an article: "today with modern methods of treatment and patient assessment.. haemophiliacs are able to lead a near-normal, albeit hazardous, life. Their great salvation comes in small plastic bags containing as the cryoprecipitate."

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Dr Delamore preferred to administer cryoprecipitate but observed that if freeze-dried concentrate could be altered to be dissolved more easily and in smaller volume, "we would probably choose that preparation in preference to cryoprecipitate."

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The annual return for 1976 showed substantial use of cryoprecipitate, NHS concentrate and Kryobulin, with some use of Hemofil. Both FEIBA and porcine Factor 8 were also used in Manchester Haemophilia Centre.

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1977 saw an increase in the volume of NHS concentrate used at the Manchester Royal Infirmary, but a greater volume of commercial as well.

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In 1978, NHS concentrate was used in greatest measure at the Manchester Royal Infirmary, but significant quantities of commercial concentrates and cryoprecipitate were also used.

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In 1979, NHS concentrate was used in the greatest measure at the Manchester Royal Infirmary but with large quantities of commercial concentrates and cryoprecipitate all used as well.

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It was observed that usage of cryoprecipitate in the North West region remained high in comparison with the national position, due to the policies adopted by the regional haemophilia service.

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Dr Wensley recorded that the NHS concentrate compared well with commercial. and that he was gradually changing his home treatment patients from commercial to NHS concentrate, with the plan that commercial concentrate would then be used only in operations.

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Dr Wensley reported that certain batches of Factor VIII concentrate had failed to comply with the new B.P. limit.

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Dr Gunson stated that Dr Wensley "worked very hard and devised a semi-automated method for producing high quality cryoprecipitate from which the patients in the region derived considerable benefit."

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Dr Delamore identified the incidence of hepatitis in haemophilia as being the highest priority in a March 1977 letter to Dr Rizza.

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An AIDS information leaflet was determined to be in the best interests of public health, despite potential sensitivity relating to homosexuals. Ministers were asked to agree to the funding and publication.

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Information was provided regarding the introduction of an information leaflet on AIDS by the BTS. This information encouraged the self exclusion of high risk donors.

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