In addition, co morbid conditions may further complicate the management of adult patients with or without inhibitors; the most serious include human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infections arthritis, osteoporosis, and obesity. HIV- and HCV-positive individuals may contend with significant clinical problems related to acquired immunodeficiency syndrome (AIDS) or liver disease, both of which are associated with increased bleeding symptoms and clotting factor consumption. Increased incidences of osteoporosis and arthritis may result from recurring hemarthroses and frequent limb immobilization. Higher body mass index, an increasing problem among all segments of the US population, can be particularly problematic for patients with arthropathy in weight-bearing joints because it is associated with greater limitations of ROM.As with any aging population, older patients with inhibitors may also experience other co-morbid conditions such as diabetes, hypertension, renal disease, and cancer.