Decompensated cirrhosis (Child-Pugh B or C): ascites, encephalopathy, variceal bleeding,...

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

ID	`RF-DECOMP-CIRRHOSIS`
Type	Red flag
Status	reviewed 2026-04-25 \| pending_clinical_signoff
Diseases	`DIS-HCV-MZL`
Sources	`SRC-EASL-HCV-2023` `SRC-ESMO-MZL-2024`

Red Flag Origin

Definition	Decompensated cirrhosis (Child-Pugh B or C): ascites, encephalopathy, variceal bleeding, or jaundice from cirrhosis
Clinical direction	de-escalate
Category	organ-dysfunction
Shifts algorithm	ALGO-HCV-MZL-1L

Trigger Logic

{
  "any_of": [
    {
      "finding": "child_pugh_class",
      "value": "B"
    },
    {
      "finding": "child_pugh_class",
      "value": "C"
    },
    {
      "finding": "decompensated_cirrhosis",
      "value": true
    }
  ],
  "type": "lab_value"
}

Notes

Major modifier: contraindicates protease-inhibitor-containing DAA (glecaprevir/pibrentasvir) — switch to SOF/VEL+RBV. Also restricts bendamustine dosing severely.

Used By

Algorithms

ALGO-HCV-MZL-1L - ALGO-HCV-MZL-1L

Indications

IND-HCV-MZL-1L-BR-AGGRESSIVE - IND-HCV-MZL-1L-BR-AGGRESSIVE
IND-NMZL-1L-HCV-POSITIVE - IND-NMZL-1L-HCV-POSITIVE
IND-SMZL-1L-HCV-POSITIVE - IND-SMZL-1L-HCV-POSITIVE

Questionnaires

QUEST-HCV-MZL-1L - HCV-associated Marginal Zone Lymphoma — first line