Infección activa o latente que requiere resolución / profilaxis antes de iniciar gemcitabi...

Vista determinista de la entidad fuente YAML. La autoridad clínica sigue con los ID de fuente citados y estado de firma del revisor.

ID	`RF-CHOLANGIOCARCINOMA-INFECTION-SCREENING`
Tipo	Señal de alerta
Situación	reviewed 2026-04-27 \| pending_clinical_signoff
Enfermedades	`DIS-CHOLANGIOCARCINOMA`
Fuentes	`SRC-ESMO-BTC-2023` `SRC-NCCN-HEPATOBILIARY`

Origen de la bandera roja

Definición	Active or latent infection requiring resolution / prophylaxis before initiating gemcitabine + cisplatin + durvalumab or FGFR2/IDH1-targeted therapy: HBsAg-positive (HBV reactivation risk on chemoimmunotherapy + durvalumab), anti-HBc-positive (occult HBV), HIV-positive (ART coordination required), or active TB. Cholangitis from biliary obstruction is also addressed in transformation-progression flag.
Dirección clínica	Atención
Categoría	detección de infecciones

Lógica de activación

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

Notas

HBsAg+: entecavir / tenofovir prophylaxis before durvalumab + gem-cis (immune-checkpoint inhibitors carry HBV reactivation signal even in HBsAg-negative / anti-HBc-positive patients). HIV+ biliary cancer manageable with TOPAZ-1 regimen but requires ART coordination — avoid ritonavir-boosted PIs with TKIs (CYP3A4 interactions with FGFR / IDH inhibitors). Active TB: anti-TB completion preferred before chemoimmunotherapy. This flag operationalizes the hold via parallel supportive-care workup rather than indication switch.

Utilizado por

No se encuentran referencias inversas en el corpus YAML.