Privacy-preserving genomic testing in the clinic: a model using HIV treatment.
Privacy-preserving genomic testing in the clinic: a model using HIV treatment.
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DOI：
10.1038/gim.2015.167
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发表时间：
2016-08
期刊：
影响因子：
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通讯作者：
Telenti A
中科院分区：
文献类型：
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作者：
McLaren PJ;Raisaro JL;Aouri M;Rotger M;Ayday E;Bartha I;Delgado MB;Vallet Y;Günthard HF;Cavassini M;Furrer H;Doco-Lecompte T;Marzolini C;Schmid P;Di Benedetto C;Decosterd LA;Fellay J;Hubaux JP;Telenti A
数据隐私和向保健从业人员提供解释结果方面的未决问题阻碍了基因组医学的实施。我们使用基于DNA的HIV相关结果预测作为模型来探索临床基因组学中的关键问题。Genet Med 18 8，814-822。我们对HIV阳性个体中的4,149个标记进行了基因分型。变异允许预测17个性状相关的艾滋病毒的医疗保健，推断患者的祖先，和人类白细胞抗原（HLA）类型的插补。遗传数据在隐私保护框架下使用同态加密进行处理，并将描述潜在可操作结果的临床报告交付给医疗保健提供者。Genet Med 18 8，814-822。共有230名患者被纳入研究。我们证明了加密大量遗传标记、推断患者血统、计算单基因和多基因性状风险以及在隐私保护条件下报告结果的可行性。在标准计算机上，对加密数据进行多标记测试的平均执行时间为865 ms。测试返回潜在可操作的遗传结果的比例从0到54%不等。Genet Med 18 8，814-822。本文提出的实施模型为临床护理提供基因组测试结果的策略提供了信息。确保隐私的数据加密有助于建立患者信任，这是基因组医学道路上的关键要求。Genet Med 18 8，814-822。
The implementation of genomic-based medicine is hindered by unresolved questions regarding data privacy and delivery of interpreted results to health-care practitioners. We used DNA-based prediction of HIV-related outcomes as a model to explore critical issues in clinical genomics. Genet Med 18 8, 814–822. We genotyped 4,149 markers in HIV-positive individuals. Variants allowed for prediction of 17 traits relevant to HIV medical care, inference of patient ancestry, and imputation of human leukocyte antigen (HLA) types. Genetic data were processed under a privacy-preserving framework using homomorphic encryption, and clinical reports describing potentially actionable results were delivered to health-care providers. Genet Med 18 8, 814–822. A total of 230 patients were included in the study. We demonstrated the feasibility of encrypting a large number of genetic markers, inferring patient ancestry, computing monogenic and polygenic trait risks, and reporting results under privacy-preserving conditions. The average execution time of a multimarker test on encrypted data was 865 ms on a standard computer. The proportion of tests returning potentially actionable genetic results ranged from 0 to 54%. Genet Med 18 8, 814–822. The model of implementation presented herein informs on strategies to deliver genomic test results for clinical care. Data encryption to ensure privacy helps to build patient trust, a key requirement on the road to genomic-based medicine. Genet Med 18 8, 814–822.