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Co-infecção por hepatite B: HBsAg positivo OR anti-HBc positivo total (risco de VHB oculto). VHC...

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IDRF-HBV-COINFECTION
TipoSinal de alerta
Estadoreviewed 2026-04-25 | pending_clinical_signoff
DoençasDIS-HCV-MZL
FontesSRC-EASL-HCV-2023 SRC-NCCN-BCELL-2025

Origem da bandeira vermelha

DefiniçãoHepatitis B coinfection: HBsAg positive OR anti-HBc total positive (occult HBV risk). HCV-MZL-specific surveillance flag — universal HBV reactivation handling lives in RF-UNIVERSAL-HBV-REACTIVATION-RISK.
Direcção clínicainvestigar
Categoriarastreamento de infecções

Lógica de Desencadeamento

{
  "any_of": [
    {
      "finding": "hbsag",
      "value": "positive"
    },
    {
      "finding": "anti_hbc_total",
      "value": "positive"
    }
  ],
  "type": "lab_value"
}

Notas

HBV co-infection in HCV-MZL patients triggers MDT-brief annotation recommending HBV-prophylaxis (entecavir or TDF) before any anti-CD20 exposure. Reactivation rates without prophylaxis: ~50% in HBsAg+, 5-10% in anti-HBc+ (occult HBV). Algorithm choice between ANTIVIRAL and BR-AGGRESSIVE arms is not affected — both arms can proceed with HBV prophylaxis in parallel. The cross-disease/universal HBV reactivation handling (HBsAg+, anti-HBc+, HBV-DNA detectable) is consolidated into RF-UNIVERSAL-HBV-REACTIVATION-RISK. This disease-specific entry kept for backwards compatibility with existing HCV-MZL plans; new diseases should rely on the universal flag instead.

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