Active or latent infection requiring resolution / prophylaxis before initiating cytotoxic...

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

ID	`RF-ENDOMETRIAL-INFECTION-SCREENING`
Type	Red flag
Status	reviewed 2026-04-27 \| pending_clinical_signoff
Diseases	`DIS-ENDOMETRIAL`
Sources	`SRC-ESMO-ENDOMETRIAL-2022` `SRC-NCCN-UTERINE-2025`

Red Flag Origin

Definition	Active or latent infection requiring resolution / prophylaxis before initiating cytotoxic chemo (carbo+pacli, doxorubicin-containing for carcinosarcoma) or ICI (pembro / dostarlimab) in endometrial cancer: HBsAg-positive (HBV reactivation risk on cytotoxic chemo and on ICI; doxorubicin notable for HBV reactivation in non-lymphoma settings), anti-HBc-positive (occult HBV), HIV-positive, 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
    },
    {
      "finding": "active_uncontrolled_infection",
      "value": true
    }
  ],
  "type": "composite"
}

Notes

HBV reactivation on doxorubicin-containing carcinosarcoma regimens (ifosfamide-paclitaxel, carbo-paclitaxel-doxorubicin) is documented; HBsAg+ → mandatory entecavir or tenofovir prophylaxis from before first cycle through ≥6 months post-last-chemo (ASCO HBV guidance). ICI (pembro / dostarlimab): chronic HBV not absolute contraindication but suppress viral load with antiviral first; HIV well controlled on ART can receive ICI safely. Direction "hold" surfaces a workup- prerequisite annotation rather than switching indication.

Used By

No reverse references found in the YAML corpus.