Onco Wiki / Bandera roja

Infección activa o latente que requiere resolución / profilaxis antes de iniciar carbo+pac...

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

IDRF-OVARIAN-INFECTION-SCREENING
TipoSeñal de alerta
Situaciónreviewed 2026-04-27 | pending_clinical_signoff
EnfermedadesDIS-OVARIAN
FuentesSRC-ESMO-OVARIAN-2024 SRC-NCCN-OVARIAN-2025

Origen de la bandera roja

DefiniciónActive or latent infection requiring resolution / prophylaxis before initiating carbo+pacli ± bevacizumab and PARPi maintenance in advanced ovarian: HBsAg+ or anti-HBc+ (HBV reactivation on cytotoxic chemo; bevacizumab adds GI / wound-healing complications during reactivation hepatitis), HCV-RNA+, HIV+, active TB, active uncontrolled infection.
Dirección clínicaAtención
Categoríadetección de infecciones
Algoritmo de cambiosALGO-OVARIAN-ADVANCED-1L

Lógica de activación

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

Notas

HBsAg+ → entecavir or tenofovir from before first cycle through ≥6 months post-last-chemo / PARPi (PARPi maintenance can be 2-3 years in BRCA+ — extend prophylaxis duration). Bevacizumab during unrecognized HBV reactivation can cause hepatic decompensation and worsen GI mucosal-healing complications (perforation risk). HIV+ with stable ART can receive standard regimens. Active TB: complete intensive-phase anti-TB before initiating chemo. Direction "hold" surfaces a workup-prerequisite annotation rather than switching indication.

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