Table 2.

Recommendations for avoiding complications from ruxolitinib-associated infections in polycythemia vera (PV).

Recommended Actions/Tests	In Detail
Accurate history taking at the start and physical examination	Identify risk groups for infections like tuberculosis, identify other reasons for immunosuppression, and identify co-medication [70,71].
Baseline virology	Hepatitis B [70,71]. No consensus in favor of routine testing for HCV and HIV.
Hepatitis B screening	Includes HBsAg, anti-HBs, and anti-HBc [70]. If anti-HBc is positive, determine HBV-DNA [72].
Test in hepatitis B virus carriers	Close monitoring of liver function and plasma HBV-DNA level. Referral to a specialist [70].
Test, if tuberculosis is suspected	Tuberculin Skin Test (TST) or (preferably) IFN-γ Release Assay, IGRA (i.e., Quanti-FERON test) [70,72].
Vaccination	Age-appropriate vaccination against influenza, herpes zoster, and pneumococci [3,74]. Vaccination against meningococcal infection in patients with pre-existing comorbidity or the immune system *.
Varicella zoster virus (VZV)	No primary but secondary prophylaxis in individual cases. Inform and educate patients to seek immediate medical attention if signs of cutaneous herpes zoster develop [72]. VZV reactivation: consider vaccination against VZV with inactivated vaccine.

* According to STIKO, vaccination for meningococcal infection is suggested for those with an additional pre-existing comorbidity of the immune system [74].