Active or unmanaged infection requiring resolution before initiating cisplatin-based chem...

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

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

Red Flag Origin

Definition	Active or unmanaged infection requiring resolution before initiating cisplatin-based chemoradiation in cervical cancer: HIV-positive (HPV-driven disease — almost universal HIV testing recommended; CD4 informs cisplatin dosing and pelvic-RT field tolerance), HBV-positive (reactivation risk on prolonged chemoradiation), active pelvic abscess / pyometra (must drain before RT), or active TB.
Clinical direction	hold
Category	infection-screening

Trigger Logic

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

Notes

HIV testing recommended for all cervical cancer patients per NCCN (HPV / HIV co-infection extremely common). HIV+ patients tolerate cisplatin-CRT with ART optimization; CD4 <200 is relative contraindication — coordinate with HIV clinic. HBV+: entecavir/tenofovir prophylaxis during prolonged chemo phases. Pelvic abscess / pyometra: percutaneous drainage / antibiotics first; RT into infected field worsens necrosis. This RF surfaces workup-prerequisites; engine does not switch indication.

Used By

Indications

IND-CERVICAL-METASTATIC-1L-PEMBRO-CHEMO-BEV - IND-CERVICAL-METASTATIC-1L-PEMBRO-CHEMO-BEV