MDS patient with positive HBV / HCV / HIV serology, latent TB, or active uncontrolled inf...

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

ID	`RF-MDS-INFECTION-SCREENING`
Type	Red flag
Status	reviewed 2026-04-25 \| pending_clinical_signoff
Diseases	`DIS-MDS-HR` `DIS-MDS-LR`
Sources	`SRC-ESMO-MDS-2021` `SRC-NCCN-AML-2025`

Red Flag Origin

Definition	MDS patient with positive HBV / HCV / HIV serology, latent TB, or active uncontrolled infection — needs antiviral prophylaxis before HMA initiation (HBV reactivation reported with azacitidine and decitabine)
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_uncontrolled_infection",
      "value": true
    }
  ],
  "type": "composite"
}

Notes

Direction "hold" surfaces a workup prerequisite. HBV testing mandatory pre-HMA. HMA-induced cytopenias prolong infection windows; pre-existing infections must be controlled before initiation. STUB — requires clinical co-lead signoff.

Used By

Algorithms

ALGO-MDS-HR-1L - ALGO-MDS-HR-1L
ALGO-MDS-HR-2L - ALGO-MDS-HR-2L
ALGO-MDS-LR-1L - ALGO-MDS-LR-1L
ALGO-MDS-LR-2L - ALGO-MDS-LR-2L

Indications

IND-MDS-HR-ALLOHCT - IND-MDS-HR-ALLOHCT
IND-MDS-LR-2L-IMETELSTAT - IND-MDS-LR-2L-IMETELSTAT