Until the 1960s, the life expectancy with hemophilia was only 20 to 30 years. Today, thanks to better treatments, people with hemophilia can live much longer, healthier lives. Treatments include clotting factor replacement and cutting-edge gene therapies.

In this article, we’ll cover what the life expectancy is for someone living with hemophilia A and how it’s changed over the years. We’ll also cover how severity and complications may affect prognosis and how new treatments may help.

Life Expectancy Over Time

Hemophilia A is a blood clotting or bleeding disorder caused by low levels of clotting factors. These proteins help your blood create clots. People with hemophilia A have mutations (changes) in the gene that controls factor VIII (8) production. People without enough of the clotting factor VIII protein are at a high risk of bleeding episodes. (You will usually see Roman numerals in any discussion of clotting factors.)

The type of hemophilia you have depends on how much factor VIII your blood contains. Most people with severe hemophilia A have less than 1 percent of normal factor VIII levels.

To show how treatment for hemophilia A has improved, we’ll look back at nearly 100 years of progress.

The Development of Replacement Clotting Factor

In the early 20th century, people with hemophilia had very few treatment options, and most faced a poor outlook. But by the 1940s, advances in blood transfusions and plasma therapies began to improve survival and change the future of hemophilia care. In 1964, researchers found a way to separate clotting factors from donor blood. The resulting treatment improved the average life expectancy for people with hemophilia to 24 years.

In the 1980s, tragedy struck when clotting factor concentrates made from donated blood were contaminated with the human immunodeficiency virus (HIV) and hepatitis C virus (HCV). Healthcare facilities had to take extra steps to properly clean and filter the clotting factors to prevent recipients from developing life-threatening complications. Even so, many people with hemophilia were affected, and hepatitis and AIDS became major causes of death.

By the 1990s, stronger safety measures were in place. Blood donors were screened, and viral inactivation methods — which involve either removing viruses from samples or making them noninfectious — were used. These steps made plasma-derived factor concentrates very safe.

No confirmed cases of HIV or hepatitis C have been linked to modern clotting factor products. However, doctors note that, theoretically, there is a small risk of new or emerging infections.

Recombinant Clotting Factors Reduce Infections

In the 1980s and 1990s, scientists learned how to make factor VIII in a lab without using human blood. This was a major step forward. These lab-made proteins are called recombinant clotting factors.

Prophylactic clotting factor replacement therapy reduces the risk of life-threatening complications like brain bleeds, but comes with a risk of developing inhibitors.

The U.S. Food and Drug Administration (FDA) has approved both human and recombinant factor VIII treatments. These recombinant therapies have nearly eliminated infection risk.

Better Treatments Have Improved Survival

People with hemophilia are living longer than ever before. A large study from the Netherlands looked at more than 1,000 men with hemophilia. From 1973 to 1986, the average life expectancy was about 66 years. From 2001 to 2018, it went up to 77 years.

During those same years, men in the general population lived longer too — from 79 to 83 years. This means that many people with hemophilia can now live almost as long as people without the disease.

Prophylactic Treatment, Survival, and Quality of Life

Prophylaxis means taking medicine to prevent a health problem before it happens. In hemophilia, prophylactic treatment helps prevent bleeding and long-term joint damage.

Children with severe hemophilia A often begin this treatment early in life. Regular clotting factor replacement therapy helps keep factor VIII levels steady. This lowers the risk of bleeding into joints and muscles and protects movement and quality of life.

About 30 percent of people with severe hemophilia A develop inhibitors. These are immune proteins that make clotting factor less effective and hemophilia harder to treat. When this happens, bleeds are harder to control.

Today, several nonfactor therapies are available to help:

• Concizumab (Alhemo) — An antibody (immune protein) that blocks a protein that slows clotting.
• Emicizumab (Hemlibra) — An antibody that helps blood clot without using factor VIII.
• Fitusitran (Qfitlia) — A ribonucleic acid (RNA) therapy that helps the body make more clotting proteins naturally.

These treatments can be used in people with or without inhibitors to help prevent dangerous bleeding. One of the most serious types is intracranial hemorrhage, which means bleeding in or around the brain. It’s a leading cause of death among people with hemophilia.

Severity of Hemophilia and Prognosis

The severity of your hemophilia plays a big role in your outlook and treatment plan. Severity is based on how much factor VIII is in your blood:

• Mild hemophilia A — 5 percent to 40 percent of healthy factor VIII levels
• Moderate hemophilia A — 1 percent to 5 percent of healthy factor VIII levels
• Severe hemophilia A — Less than 1 percent of healthy factor VIII levels

Read more about how your doctor determines your severity.

About 60 percent of people with hemophilia A have the severe form. This means they’re more likely to have frequent or serious bleeding episodes, even without getting injured.

In the past, people with severe hemophilia had a much higher mortality (death) rate than those without the disorder. However, modern treatments have greatly narrowed this gap. A large study in the Netherlands found that from 1992 to 2001, men with severe hemophilia lived for about 59 years. Between 2001 and 2018, that number rose to 73 years.

According to the Centers for Disease Control and Prevention (CDC), the average American man lives about 76 years. This means that today, many people with severe hemophilia A in countries with strong healthcare systems are living nearly as long as the general population.

Is Hemophilia a Lifelong Disease?

Hemophilia A is a genetic condition you’re born with, and it lasts a lifetime. While there’s no cure yet, modern treatments can control bleeding and help people live a long, healthy, and largely normal life.

Gene Therapy and Prognosis

In June 2023, the FDA approved the first gene therapy for people with severe hemophilia A. This treatment is given as a one-time infusion. It uses a harmless virus to deliver a healthy copy of the factor VIII gene into your liver cells. After treatment, the liver can start making its own factor VIII protein to help your blood clot.

Before getting gene therapy, your doctor will test your blood for antibodies that might block the virus. If you have these antibodies, the therapy may not work well.

In a clinical study of 134 men with severe hemophilia A, gene therapy reduced the need for regular factor replacement therapy by about 99 percent. Overall, 90 percent of people in the study had no treated bleeds or fewer bleeds after gene therapy.

However, doctors don’t yet know if gene therapy helps people live longer. Longer-term studies are still underway to learn how long the benefits last and whether it improves life expectancy.

New Nonfactor Therapies

Nonfactor therapies give people with hemophilia more ways to prevent bleeding. These medicines don’t replace missing clotting factors. Instead, they help the blood clot in other ways.

The newest option is fiturisan (Qfitlia). It was approved by the FDA in 2025 for people ages 12 and older with or without inhibitors. It’s given by injection every one to two months. It lowers the amount of a protein called antithrombin, which helps raise the level of thrombin (factor II), which is an important part of the blood-clotting process.

Talk With Your Doctor About Your Prognosis With Hemophilia A

Every person’s hemophilia case is unique. While general information can give you an idea of your outlook and life expectancy living with this disorder, many factors can affect it. To learn more about your specific prognosis and what factors influence it, talk with your healthcare provider.

It’s also important to stick closely to your hemophilia treatment plan to prevent serious bleeding episodes and complications. You can work with your care team to create and follow a comprehensive care plan to prevent and manage bleeding with hemophilia A. As new treatments become available, you may have more options.

Join the Conversation

On MyHemophiliaTeam, people share their experiences with hemophilia, get advice, and find support from others who understand.

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