Establishment and Operation of a Biorepository for Molecular Epidemiologic Studies in Costa Rica

Abstract

Background: The Proyecto Epidemiológico Guanacaste (PEG) has conducted several large studies related to human papillomavirus (HPV) and cervical cancer in Guanacaste, Costa Rica in a long-standing collaboration with the U.S. National Cancer Institute. To improve molecular epidemiology efforts and save costs, we have gradually transferred technology to Costa Rica, culminating in state-of-the-art laboratories and a biorepository to support a phase III clinical trial investigating the efficacy of HPV 16/18 vaccine.Objective: Here, we describe the rationale and lessons learned in transferring molecular epidemiologic and biorepository technology to a developing country.Results: At the outset of the PEG in the early 1990s, we shipped all specimens to repositories and laboratories in the United States, which created multiple problems. Since then, by intensive personal interactions between experts from the United States and Costa Rica, we have successfully transferred liquid-based cytology, HPV DNA testing and serology, chlamydia and gonorrhea testing, PCR-safe tissue processing, and viable cryopreservation. To accommodate the vaccine trial, a state-of-the-art repository opened in mid-2004. Approximately 15,000 to 50,000 samples are housed in the repository on any given day, and >500,000 specimens have been shipped, many using a custom-made dry shipper that permits exporting >20,000 specimens at a time. Quality control of shipments received by the NCI biorepository has revealed an error rate of <0.2%. Recently, the PEG repository has incorporated other activities; for example, large-scale aliquotting and longterm, cost-efficient storage of frozen specimens returned from the United States. Using Internet-based specimen tracking software has proven to be efficient even across borders.Conclusion: For long-standing collaborations, it makes sense to transfer the molecular epidemiology expertise toward the source of specimens. The successes of the PEG molecular epidemiology laboratories and biorepository prove that the physical and informatics infrastructures of a modern biorepository can be transferred to a resource-limited and weather-challenged region. Technology transfer is an important and feasible goal of international collaborations. Cancer Epidemiol Biomarkers Prev; 19(4); 916-22. ©2010 AACR.

Long term protection against cervical infection with the human papillomavirus: Review of currently available vaccines

“…In addition, an observational study in Guanacaste, Costa Rica will provide a six-year follow-up of women who received the bivalent vaccine in the Costa Rican Vaccine Trial and unvaccinated women. 37 In the meantime, the head-to-head study of the two vaccines has provided compelling evidence that the bivalent vaccine induces a stronger immune response than the quadrivalent vaccine, with higher levels of neutralizing antibodies (which likely mediate protection offered by prophylactic vaccines) maintained at two years post-vaccination. 43,44 A study of the bivalent vaccine has shown that levels of neutralizing antibodies against both HPV-16 and HPV-18 remain several-folds above natural infection levels up to 8.4 years after vaccination.…”

High‐resolution HLA allele and haplotype frequencies in majority and minority populations of Costa Rica and Nicaragua: Differential admixture proportions in neighboring countries

“…[14][15][16][17] Moreover, the major population of Costa Rica, that of its Central Valley, has been the subject of genetic scientific interest [18][19][20][21][22][23][24][25][26] due to its interesting demographic history including claims for relative isolation, 27,28 while that of its northwestern province of Guanacaste has been a hub for largescale human papilloma virus vaccine testing clinical trials. [29][30][31][32][33] All these characteristics make the study of HLA allele and haplotype frequencies in these countries of special interest.…”

Rationale and design of a long term follow-up study of women who did and did not receive HPV 16/18 vaccination in Guanacaste, Costa Rica

“…The staff at each clinic includes a clinician, an interviewer, a field work supervisor, a driver and a janitor. The headquarters in Liberia coordinates appointments using a data-management system developed for CVT and modified for LTFU; the headquarters also houses the fully equipped biospecimen repository (24), document center, and teams of study physicians, data entry, information technology and quality control, as well as processing laboratories for cervical sample aliquotting, cytology slide production, blood processing, cryopreservation, histology, and HPV testing by hybrid capture 2 (HC2). Participant records and specimens are centralized at the Liberia headquarters and transported daily to and from the clinics in study vehicles.…”