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Infection active ou latente nécessitant une résolution / prophylaxie avant d'amorcer le carbo-pac...

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

Origine du drapeau rouge

DéfinitionActive 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.
Direction cliniqueen attente
Catégoriedépistage des infections
Algorithme de décalageALGO-OVARIAN-ADVANCED-1L

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
    },
    {
      "finding": "active_uncontrolled_infection",
      "value": true
    }
  ],
  "type": "composite"
}

Notes

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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