PMF 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-PMF-INFECTION-SCREENING`
Type	Red flag
Status	reviewed 2026-04-25 \| pending_clinical_signoff
Diseases	`DIS-PMF`
Sources	`SRC-COMFORT-I-VERSTOVSEK-2012` `SRC-NCCN-MPN-2025`

Red Flag Origin

Definition	PMF patient with positive HBV / HCV / HIV serology, latent TB, or active uncontrolled infection — ruxolitinib and other JAKi associated with HBV reactivation, TB reactivation, opportunistic infections; mandatory pre-JAKi screening + active prophylaxis
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": "latent_tb",
      "value": true
    },
    {
      "finding": "active_uncontrolled_infection",
      "value": true
    }
  ],
  "type": "composite"
}

Notes

Direction "hold" — surfaces a JAKi-prerequisite annotation. JAK inhibitors carry a real (if uncommon) risk of HBV reactivation, TB reactivation, and opportunistic infections (PJP, cryptococcal). Screening + prophylaxis must be in place before initiation. STUB — requires clinical co-lead signoff.

Used By

Indications

IND-PMF-1L-RUXOLITINIB - IND-PMF-1L-RUXOLITINIB
IND-PMF-ALLOHCT-HIGH-RISK - IND-PMF-ALLOHCT-HIGH-RISK
IND-PMF-MOMELOTINIB-ANEMIA - IND-PMF-MOMELOTINIB-ANEMIA