The Infectious Diseases BioBank (IDB) at King's College London,United Kingdom

Introduction

The Infectious Diseases BioBank (IDB) was established following the awards of grants from the Guy's and St. Thomas' Charity and subsequently the UK's National Institute of Health Research comprehensive Biomedical Research Centre (NIHR cBRC) at Guy's and St. Thomas' Hospitals. Physically, the IDB is located at Guy's Hospital in South East London and includes a local catchment area that has significant levels of infectious diseases resulting from high levels of immigration and poverty. Indeed, 1% of pregnant women attending to deliver babies at St. Thomas' Hospital are positive for human immunodeficiency virus (HIV) and 2% are already infected with hepatitis B. Consequently our interests reflect these local problems as well as the interests of local NHS and University researchers, with major collections of blood fractions (live lymphocytes, sera, plasma, DNA and RNA) from patients infected with HIV, hepatitis B or C as well as bacteremias. The major collection features longitudinal samples from HIV patients with particularly interesting clinical disease features (e.g., those who have either a very slow or fast progression to disease, the new seroconverters etc.). These samples are primarily collected from tissue collection centres (TCC) located at Guy's, St. Thomas' and Kings College Hospitals, with new TCCs opening in 2012 at St. Mary's and the Chelsea and Westminster Hospitals in London. The TCCs obtain (broad) informed consent from patients (infants, children or adults) attending routine appointments to enable virtually any type of research to be performed. They also collect research (blood, urine or feces) or residual diagnostic (any type) samples and anonymize them with extensive clinical details before couriering the samples to the IDB for fractionation and preservation. All infectious samples are handled in a Category III laboratory and the IDB has a DNA/RNA extraction robot to isolate nucleic acids.

Researchers (academic or industrial) wishing to access the samples fill in a simple two-page application form which is located on the IDB website (http://www.kcl.ac.uk/medicine/research/divisions/diiid/about/facilities/biobank/index.aspx). Applications are reviewed by the IDB's scientific/ethical committee. This includes scientists, clinicians, a representative of the funding body, and a patient representative. Successful applicants do not have to obtain any other permissions (e.g., from NHS research and development committees, ethics permissions or a UK human tissue license) to work on and store these samples for a period of three years. Applicants may be asked to pay a processing charge, and a set of tiered charges for different fractions is available on request. Researchers are required to sign a materials transfer agreement, confirm that all samples have been used up at the end of their permission, and provide raw experimental data back to the IDB. The great challenge to the IDB is collating the data, and a state of the art laboratory information management system is currently under construction for the IDB.

The IDB has more recently expanded to include: (i) other inflammatory diseases of adults and of children; (ii) a processing center for the human immune response dynamics study (a longitudinal study of subjects immunized with influenza vaccine; and (iii) custodianship of samples from the HIV SPARTAC trial.

Site location: Guy's Hospital London SE1 9RT

Contact info:

Web: http://www.kcl.ac.uk/medicine/research/divisions/diiid/about/facilities/biobank/index.aspx

E-mail: john.cason@kcl.ac.uk

Contact: John Cason, IDB Director

Date of operations (date of formal start of current bank operation): December 2006

Date range of cases: December 2006 to present

Category of biobank: Translational/Clinical

Focus of biobank: Infectious/inflammatory diseases, notably:

• Human immunodeficiency virus: ∼400 patients followed longitudinally (∼1,500 patient visits)

Membership of biobanks (networks, affiliations): ESBB: European, Middle East and African Society for Biopreservation and BioBanking; CHERUB: Collaborative HIV Eradication of Reservoirs; SPARTAC: Short Pulse Anti Retroviral Therapy at HIV Seroconversion; HIRD: Human Immune Response Dynamics

Major source of funding:

Guy's and St Thomas' Charity

Proportional funding sources for biobank:

Institutional core budget: 0%

Example input statistics (bank as a whole):

Total number patient visits: 2,455

Example output statistics:

Number of ongoing ethical permissions for studies: 17

In your view, what are the most valuable/highest priority cases in your biobanks?

Those with complete longitudinal sets of samples from HIV patients with full clinical details, viral sequence data, and HLA types.

What are your major challenges?

1. Insecure funding.

What would you do with $1 million to improve the value of your biobanks?

Obtain further technical assistance and a data manager to collate the inexorable amount of information that is accruing on the HIV infected patients.