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Infection active ou latente nécessitant une résolution / prophylaxie avant d'amorcer l'ABVD / A+...

Vue déterministe de l'entité source de la LJAM. L'autorité clinique demeure avec les ID de la source cités et l'état d'approbation de l ́examinateur.

IDRF-CHL-INFECTION-SCREENING
TypeSignal d’alerte
Étatreviewed 2026-04-27 | pending_clinical_signoff
MaladiesDIS-CHL
SourcesSRC-ESMO-HODGKIN-2024 SRC-NCCN-BCELL-2025

Origine du drapeau rouge

DéfinitionActive or latent infection requiring resolution / prophylaxis before initiating ABVD / A+AVD / BEACOPP in classical Hodgkin lymphoma: HBsAg-positive (HBV reactivation risk on prolonged steroid-free chemo is moderate, but high if BEACOPP with prednisone), anti-HBc-positive (occult HBV), HCV-RNA-positive, HIV-positive (HIV-Hodgkin association, often EBV-driven), or active TB.
Direction cliniqueen attente
Catégoriedépistage des infections

Logique de déclenchement

{
  "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
    }
  ],
  "type": "lab_value"
}

Notes

HBsAg+ → entecavir or tenofovir prophylaxis throughout chemo + 6-12 mo post (particularly important if escalated BEACOPP — prolonged steroid + alkylator load). HIV+ cHL: continue ART, full-dose ABVD (or A+AVD if fit) — outcomes approach HIV-negative cHL; avoid BEACOPP in HIV (excess toxicity). Active TB: full anti-TB course before chemo when feasible. PJP prophylaxis (TMP-SMX) not routine on ABVD but recommended on BEACOPP-escalated. EBV detectable ~30-40% cHL — informative not actionable for treatment selection.

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Algorithmes