Risk of HBV reactivation prior to immunosuppressive / cytotoxic therapy: HBsAg-positive (...
Детермінований перегляд YAML-сутності з джерельної бази. Клінічний авторитет лишається за вказаними source ID та статусом клінічного sign-off.
| ID | RF-UNIVERSAL-HBV-REACTIVATION-RISK |
|---|---|
| Тип | Тривожна ознака |
| Статус | переглянуто 2026-04-25 | очікує клінічного підпису |
| Хвороби | Не вказано |
| Джерела | SRC-EASL-HCV-2023 SRC-NCCN-BCELL-2025 |
Походження тривожної ознаки
| Визначення | Risk of HBV reactivation prior to immunosuppressive / cytotoxic therapy: HBsAg-positive (high-risk) OR HBsAg-negative + anti-HBc-positive (occult HBV, intermediate risk). Applies to anti-CD20 (rituximab, obinutuzumab), BTKi, autoSCT, and any high-dose corticosteroid regimen. |
|---|---|
| Клінічний напрям | hold |
| Категорія | infection-screening |
Логіка спрацьовування
{
"any_of": [
{
"finding": "hbsag",
"value": "positive"
},
{
"finding": "anti_hbc_total",
"value": "positive"
},
{
"finding": "hbv_dna_detectable",
"value": true
}
],
"type": "lab_value"
}
Нотатки
Mandates entecavir or tenofovir prophylaxis from -7 days through +12 months post-last-anti-CD20 (NCCN B-Cell v2.2025 §HBV-1). Reactivation rate without prophylaxis: 30-50% in HBsAg+, 5-10% in HBsAg-/anti-HBc+ cohorts receiving anti-CD20 (Huang et al. 2014, Seto et al. 2014). Replaces the disease-specific RF-HBV-COINFECTION pattern; that RF is retained for ALGO-HCV-MZL-1L pending the clinical-co-lead decision in docs/plans/archive/rf_wiring_audit_2026-04-25.md.
Де використовується
Algorithms
ALGO-DLBCL-1L- ALGO-DLBCL-1L
Contraindications
CI-HBV-NO-PROPHYLAXIS- CI-HBV-NO-PROPHYLAXIS
Indications
IND-DLBCL-1L-RCHOP- IND-DLBCL-1L-RCHOPIND-NMZL-1L-HCV-POSITIVE- IND-NMZL-1L-HCV-POSITIVE
Тривожна ознака
RF-B-ALL-INFECTION-SCREENING- HBV/HCV/HIV/CMV serology + latent TB testing mandatory pre-induction; rituximab-containin...RF-BREAST-INFECTION-SCREENING- HBV/HCV/HIV serology + dental evaluation pre-bisphosphonate/denosumab + DPYD genotyping f...RF-HBV-COINFECTION- Hepatitis B coinfection: HBsAg positive OR anti-HBc total positive (occult HBV risk). HCV...RF-HCC-HBV-REACTIVATION-RISK- HBV-positive HCC patient (any HBsAg+ OR anti-HBc+ status). Anti-tumor therapy — especiall...RF-HGBL-DH-INFECTION-SCREENING- HBV/HCV/HIV serology mandatory pre-rituximab; HIV-associated HGBL-DH gets cART optimizati...RF-NMZL-INFECTION-SCREENING- HBV/HCV/HIV serology mandatory pre-rituximab; no NMZL-specific infectious driver establis...RF-NSCLC-INFECTION-SCREENING- Active TB OR latent TB conversion risk — ICI may trigger TB reactivation; pre-treatment I...RF-PMBCL-INFECTION-SCREENING- Pre-treatment HBV/HCV/HIV serology mandatory before rituximab; HBsAg+ requires antiviral...