HCV RNA PCR mandatory at SMZL diagnosis — HCV-driven SMZL responds to direct-acting antiv...

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

ID	`RF-SMZL-INFECTION-SCREENING`
Type	Red flag
Status	reviewed 2026-04-25 \| pending_clinical_signoff
Diseases	`DIS-SPLENIC-MZL`
Sources	`SRC-ESMO-MZL-2024` `SRC-NCCN-BCELL-2025`

Red Flag Origin

Definition	HCV RNA PCR mandatory at SMZL diagnosis — HCV-driven SMZL responds to direct-acting antivirals (DAA) with regression in 50-75%; rituximab deferred until antiviral response assessed.
Clinical direction	intensify
Category	infection-screening
Shifts algorithm	ALGO-SMZL-1L

Trigger Logic

{
  "any_of": [
    {
      "finding": "hcv_rna_positive",
      "value": true
    },
    {
      "finding": "anti_hcv",
      "value": "positive"
    }
  ],
  "type": "biomarker"
}

Notes

HCV-positive SMZL is etiologically distinct — DAA antiviral therapy alone induces lymphoma response in majority. Rituximab reserved for HCV-negative or DAA non-responders.

Used By

Algorithms

ALGO-SMZL-1L - ALGO-SMZL-1L