Active or latent infection requiring resolution / prophylaxis before initiating PCV or te...

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

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

Red Flag Origin

Definition	Active or latent infection requiring resolution / prophylaxis before initiating PCV or temozolomide adjuvant for low-grade glioma: HBsAg-positive (HBV reactivation on cytotoxic chemotherapy plus steroid co-therapy common with brain edema), anti-HBc-positive (occult HBV), HIV-positive (ART coordination + Pneumocystis prophylaxis), or active TB. Steroid-induced reactivation amplifies risk.
Clinical direction	hold
Category	infection-screening

Trigger Logic

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

Notes

Brain-tumor patients commonly receive concurrent dexamethasone for edema — chronic steroid exposure compounds HBV-reactivation risk on temozolomide / PCV. HBsAg+ → entecavir / tenofovir prophylaxis pre- chemo through 12 mo post. HIV+ glioma patients require Pneumocystis prophylaxis on dex + alkylator combo (lymphopenia is profound). Active TB: complete anti-TB before chemoradiotherapy when feasible; isoniazid hepatotoxicity + temozolomide hepatic clearance create monitoring burden. Surfaces hold via parallel pre-treatment workup rather than indication switch.

Used By

No reverse references found in the YAML corpus.