HBV-positive HCC-Patienten (jeder HBsAg+ oder Anti-HBc+-Status).

Deterministische Ansicht der Quelle YAML Entität. Klinische Autorität bleibt mit den zitierten Quell-IDs und Rezensenten Sign-off Zustand.

ID	`RF-HCC-HBV-REACTIVATION-RISK`
Art	Warnhinweis
Status	reviewed 2026-04-26 \| pending_clinical_signoff
Erkrankungen	`DIS-HCC`
Quellen	`SRC-AASLD-HCC-2023` `SRC-NCCN-HCC-2025`

Ursprung der Roten Flagge

Begriffsbestimmung	HBV-positive HCC patient (any HBsAg+ OR anti-HBc+ status). Anti-tumor therapy — especially anti-VEGF (bev) and ICI — can precipitate HBV reactivation with ALT flare and hepatic decompensation in unprophylaxed patients. Mandates entecavir/TDF prophylaxis throughout treatment + ≥12 mo post.
Klinische Richtung	Halten
Kategorie	Infektionsuntersuchungen

Logik auslösen

{
  "any_of": [
    {
      "finding": "hbsag",
      "value": "positive"
    },
    {
      "finding": "anti_hbc_total",
      "value": "positive"
    },
    {
      "finding": "hbv_dna_detectable",
      "value": true
    }
  ],
  "type": "lab_value"
}

Anmerkungen

HCC-specific HBV gate — separate from RF-UNIVERSAL-HBV-REACTIVATION-RISK because HCC patients have higher baseline viremia + cirrhotic substrate. Entecavir or tenofovir disoproxil/alafenamide acceptable; concurrent with HCV-DAA pathway acceptable when both viruses present.

Verwendet von

Anwendungsgebiet

IND-HCC-SYSTEMIC-1L-ATEZO-BEV - IND-HCC-SYSTEMIC-1L-ATEZO-BEV