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

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

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

Red Flag Origin

Definition	Active or latent infection requiring resolution / prophylaxis before initiating systemic MF/Sézary therapy: HBsAg-positive (HBV reactivation risk on prolonged systemic therapy with steroid co-medication), anti-HBc-positive (occult HBV), HCV-RNA-positive, HIV-positive (HTLV-1 in differential — must distinguish from ATLL — see DIS-ATLL workup pathway), HTLV-1-positive (reclassify as ATLL), or active skin superinfection (MF skin disease frequently superinfected with S. aureus — antibiotics before topical/systemic intensification).
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": "htlv1_status",
      "value": "positive"
    },
    {
      "finding": "active_skin_infection",
      "value": true
    },
    {
      "finding": "active_tb",
      "value": true
    }
  ],
  "type": "lab_value"
}

Notes

HTLV-1 testing is mandatory in any "MF/Sézary" workup per WHO 2022 — HTLV-1+ T-cell lymphoma is ATLL (separate disease entity DIS-ATLL with fundamentally different therapeutic approach: mogamulizumab, IFN+AZT, zidovudine combinations). Misdiagnosis of ATLL as MF/Sézary common in endemic regions. Skin superinfection (S. aureus, occasionally HSV) is major comorbidity in advanced MF — surveillance cultures, mupirocin / systemic antibiotics; sepsis is a leading cause of death in advanced CTCL. PJP prophylaxis on prolonged steroids / alemtuzumab. HBV+: prophylaxis if rituximab / mogamulizumab / brentuximab planned.

Used By

No reverse references found in the YAML corpus.