Add detailed handling for HIV coinfection in treatment eligibility prompts

core/assessment_chain.py

@@ -472,6 +472,14 @@ def assemble_llm_prompt(patient_data: Dict[str, Any]) -> Dict[str, Any]:
     has_hcv = "HCV" in [c.upper() for c in coinfections] if coinfections else False
     has_hdv = "HDV" in [c.upper() for c in coinfections] if coinfections else False
 
+    # Define strings with backslashes for f-string compatibility
+    hiv_critical_line = "- **CRITICAL: HIV coinfection present - absolute treatment indication**\\n"
+    hiv_absolute_indication = "- ✅ **HBV-HIV coinfection: ABSOLUTE INDICATION** [SASLT 2021, Page 9, Grade A]\\n"
+    no_hiv_line = "- ❌ No HIV coinfection\\n"
+    hiv_rationale_line = "- If HIV coinfection: State this is an absolute Grade A indication that overrides all other criteria\\n"
+    hiv_treatment_section = "**HBV-HIV Coinfection Treatment (Grade A):**\\n- All HIV-positive patients with HBV coinfection should start ART immediately, irrespective of CD4 count [SASLT 2021, Page 9]\\n- Regimen MUST include TDF or TAF (preferably TAF for better renal/bone safety) [SASLT 2021, Page 9]\\n- Include Emtricitabine or Lamivudine as part of ART regimen\\n- Monitor for immune reconstitution syndrome (may cause HBV flare in first 3-6 months)\\n- HBV DNA and ALT at 3, 6, 12 months, then every 6-12 months\\n- HIV viral load every 3-6 months\\n- Annual HCC surveillance (ultrasound ± AFP)\\n\\n"
+    hiv_final_recommendation = "- **Emphasize that HIV coinfection makes treatment mandatory regardless of other parameters**\\n"
+
     # Build analysis prompt with mandatory eligibility decision tree
     analysis_prompt = f"""You are an expert hepatologist providing HBV treatment eligibility assessments based on SASLT 2021 guidelines.
 
@@ -594,13 +602,13 @@ Use \\n for line breaks (NOT literal newlines). Format as follows:
 
 **Patient Summary**\\n
 - Brief age, sex, key clinical parameters (3-5 bullets max)\\n
-{f"- **CRITICAL: HIV coinfection present - absolute treatment indication**\\n" if has_hiv else ""}
+{hiv_critical_line if has_hiv else ""}
 \\n
 **Treatment Eligibility Analysis**\\n
 \\n
 *Absolute Indications Check (Priority):*\\n
-{f"- ✅ **HBV-HIV coinfection: ABSOLUTE INDICATION** [SASLT 2021, Page 9, Grade A]\\n" if has_hiv else ""}
-{f"- ❌ No HIV coinfection\\n" if not has_hiv else ""}
+{hiv_absolute_indication if has_hiv else ""}
+{no_hiv_line if not has_hiv else ""}
 - Cirrhosis (F4): [Check and mark ✅ or ❌]\\n
 - Immunosuppression: [Check and mark ✅ or ❌]\\n
 - Pregnancy with high viral load: [Check and mark ✅ or ❌]\\n
@@ -620,7 +628,7 @@ Use \\n for line breaks (NOT literal newlines). Format as follows:
 \\n
 *Rationale:*\\n
 - Clearly state the PRIMARY reason for eligibility decision\\n
-{f"- If HIV coinfection: State this is an absolute Grade A indication that overrides all other criteria\\n" if has_hiv else ""}
+{hiv_rationale_line if has_hiv else ""}
 - Which specific SASLT criterion/criteria apply\\n
 - Grade of recommendation (A, B, C, or D)\\n
 \\n
@@ -629,7 +637,7 @@ Use \\n for line breaks (NOT literal newlines). Format as follows:
 \\n
 *Management Approach:*\\n
 \\n
-{"**HBV-HIV Coinfection Treatment (Grade A):**\\n- All HIV-positive patients with HBV coinfection should start ART immediately, irrespective of CD4 count [SASLT 2021, Page 9]\\n- Regimen MUST include TDF or TAF (preferably TAF for better renal/bone safety) [SASLT 2021, Page 9]\\n- Include Emtricitabine or Lamivudine as part of ART regimen\\n- Monitor for immune reconstitution syndrome (may cause HBV flare in first 3-6 months)\\n- HBV DNA and ALT at 3, 6, 12 months, then every 6-12 months\\n- HIV viral load every 3-6 months\\n- Annual HCC surveillance (ultrasound ± AFP)\\n\\n" if has_hiv else ""}
+{hiv_treatment_section if has_hiv else ""}
 **If ELIGIBLE (Standard Criteria):**\\n
 - Preferred agents: Entecavir (ETV), Tenofovir (TDF), or Tenofovir Alafenamide (TAF) [SASLT 2021, Page 8, Grade A]\\n
 - Monitor HBV DNA and ALT at 3, 6, 12 months, then every 6-12 months\\n
@@ -640,7 +648,7 @@ Use \\n for line breaks (NOT literal newlines). Format as follows:
 \\n
 *Final Recommendation:*\\n
 - Concise summary statement (2-3 sentences)\\n
-{f"- **Emphasize that HIV coinfection makes treatment mandatory regardless of other parameters**\\n" if has_hiv else ""}
+{hiv_final_recommendation if has_hiv else ""}
 - Emphasize key decision factors\\n
 
 Return ONLY the JSON object, nothing else."""