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Documented chronic EBV infection (positive EBV-PCR with persistently detectable viremia >...

Детермінований перегляд YAML-сутності з джерельної бази. Клінічний авторитет лишається за вказаними source ID та статусом клінічного sign-off.

IDRF-CHRONIC-EBV-MALIGNANCY-PREVENTION
ТипТривожна ознака
Статуспереглянуто 2026-05-18 | очікує клінічного підпису
ХворобиDIS-BURKITT
ДжерелаSRC-NCCN-BCELL-2025

Походження тривожної ознаки

ВизначенняDocumented chronic EBV infection (positive EBV-PCR with persistently detectable viremia >3 months) AND a context of elevated EBV-associated malignancy risk (post-solid-organ-transplant or post-HSCT immunosuppression, congenital immunodeficiency, or HIV co-infection). IARC Group 1 carcinogen (EBV) — established etiological driver of Burkitt lymphoma, post-transplant lymphoproliferative disorder (PTLD), nasopharyngeal carcinoma, EBV-positive DLBCL of the elderly, Hodgkin lymphoma (subset), gastric carcinoma (subset). Population-wide prevention is impractical (>90% adults seropositive globally), so the RF is gated by an additional immunocompromise context — that is where EBV viremia drives clinically actionable elevated risk and EBV-DNA monitoring is standard-of-care. Prevention-persona RedFlag (§20 ratification 2026-05-18).
Клінічний напрямinvestigate
Категоріяother

Логіка спрацьовування

{
  "all_of": [
    {
      "any_of": [
        {
          "finding": "ebv_dna_pcr",
          "value": "detectable"
        },
        {
          "finding": "ebv_viremia_status",
          "value": "positive"
        }
      ]
    },
    {
      "any_of": [
        {
          "finding": "post_transplant_immunosuppression",
          "value": true
        },
        {
          "finding": "post_hsct_immunosuppression",
          "value": true
        },
        {
          "finding": "congenital_immunodeficiency",
          "value": true
        },
        {
          "finding": "hiv_status",
          "value": "positive"
        }
      ]
    }
  ],
  "type": "lab_value"
}

Нотатки

Prevention-persona RedFlag for EBV-driven cancer prevention in immunocompromised hosts. Unlike HCV/HBV/H. pylori, there is no curative anti-EBV regimen; the prevention pathway is (a) reduce immunosuppression where feasible, (b) preemptive rituximab in post-transplant patients with rising EBV-DNA (per international PTLD guidelines), (c) periodic EBV-DNA monitoring. STUB pending Co-Lead review. Gating by additional immunocompromise context is deliberate — EBV seroprevalence is >90% in immunocompetent adults globally, so a RF triggered on EBV alone would fire universally and provide no clinical signal.

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Indications

Тривожна ознака