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

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

ID	`RF-MPNST-INFECTION-SCREENING`
Type	Red flag
Status	reviewed 2026-04-27 \| pending_clinical_signoff
Diseases	`DIS-MPNST`
Sources	`SRC-NCCN-SARCOMA` `SRC-ONCOKB`

Red Flag Origin

Definition	Active or latent infection requiring resolution / prophylaxis before initiating doxorubicin + ifosfamide neoadjuvant or pazopanib for advanced MPNST: HBsAg-positive (HBV reactivation on cytotoxic + TKI), anti-HBc-positive (occult HBV), HIV-positive (ART coordination, CYP3A4 interactions with pazopanib), or active TB.
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

Sarcoma chemotherapy regimens (AI) and pazopanib all carry meaningful HBV reactivation risk — entecavir / tenofovir prophylaxis indicated for HBsAg+ or anti-HBc+. HIV+: ART coordination — pazopanib is CYP3A4 substrate, avoid CYP3A4 inhibitors (ritonavir-boosted PIs). Active TB: complete anti-TB before cytotoxic chemotherapy when feasible. Surfaces hold via parallel pre-treatment workup rather than indication switch.

Used By

No reverse references found in the YAML corpus.