Active or latent infection requiring resolution / prophylaxis before initiating CHP-Bv /...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

ID	`RF-ALCL-INFECTION-SCREENING`
Type	Red flag
Status	reviewed 2026-04-27 \| pending_clinical_signoff
Diseases	`DIS-ALCL`
Sources	`SRC-ESMO-PTCL-2024` `SRC-NCCN-BCELL-2025`

Red Flag Origin

Definition	Active or latent infection requiring resolution / prophylaxis before initiating CHP-Bv / CHOP-class therapy in ALCL: HBsAg-positive (HBV reactivation risk on cytotoxic + steroid-containing regimen), anti-HBc-positive (occult HBV), HCV-RNA-positive, HIV-positive (requires ART coordination), or active TB.
Clinical direction	hold
Category	infection-screening

Trigger Logic

{
  "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

ALCL CHP-Bv contains prednisone + brentuximab — both depress cell-mediated immunity. HBV reactivation risk slightly lower than anti-CD20 regimens (no rituximab here) but still mandates entecavir/tenofovir prophylaxis if HBsAg+ or anti-HBc+ with detectable HBV-DNA. HIV+ ALCL: continue ART, use full-dose CHP-Bv (HIV-associated ALCL responds well to CD30-directed therapy). PJP prophylaxis (TMP-SMX) routine on prolonged steroids. This RF surfaces a workup-prerequisite annotation; engine does not switch indication.

Used By

No reverse references found in the YAML corpus.