HBV Genetic Diversity and Transfusion Safety: A Conceptual Analysis and Integrative Model

Abstract

Background: Blood transfusion carry the risk of transmitting blood-borne infections. HBV genetic diversity and transfusion safety are concepts that are increasingly used in public discourse. However, how the concepts are used and how they are defined remains unclear. The objective of this study is to clarify the concepts emanating from the research project titled «Genetic diversity of HBV and its effect on the transmission risks in blood transfusion in Gabon» and to propose an integrative model of HBV genetic diversity-Transmission risks based on these results. Methods: Three databases were used in the Quantitative analysis: Pubmed, Medline and Google Scholar. The researchers delimited the search to full articles in the databases. The eligibility criteria were based on published studies in English between January 2012 and December 2020, looking at the HBV genetic diversity and the transfusion safety. The Cochrane tool was used to assess the risk of bias. A systematic review was performed on concepts and definitions. Eligible publications were reviewed using concept analysis that led to the extraction of text data for the themes “definition”, “attributes”, “antecedents”, “consequences”, and “related concepts”. The quantitative methods was used to quantify the associations between HBV Genetic diversity and transmission risk examined in the literature. Results: A total of 2685 records were identified by primary and secondary search, of which 802 were retained after examination of titles and abstracts. A total of 144 (18%) publications were included in the review, 123 dealing with Hepatitis B Virus, 38 with Genetic diversity, 94 with Transfusion safety and 94 with Transmission risks were all coded. The final concept coding scheme contained 14 items, each with a satisfactory inter-author reliability score (r) (r ranging from 0.6 and 1), coding Hepatitis B Virus, Genetic diversity, Transfusion safety, Transmission risks, Blood donation-transmission risks, Demographic factors-transmission risks, HBsAg- transmission risks, Anti-HBc-transmission risks, Viral load-transmission risks, measurement errors- transmission risks, viral load-HBsAg, viral load-Anti-HBc, Sequencing-viral load, Genotype- transmission risks. In the resulting integrative model, the elements were mapped to different levels of care. Conclusion: This integrated theory suggests a number of directions to improve the understanding of transfusion safety in the context of HBV genetic diversity, to speak the same language. It provides a basis for creating better measures and interventions in transfusion medicine.