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dc.contributor.authorMclaren, P. J.en_US
dc.contributor.authorRaisaro, J. L.en_US
dc.contributor.authorAouri, M.en_US
dc.contributor.authorRotger, M.en_US
dc.contributor.authorAyday, E.en_US
dc.contributor.authorBartha, I.en_US
dc.contributor.authorDelgado, M. B.en_US
dc.contributor.authorVallet, Y.en_US
dc.contributor.authorGünthard, H. F.en_US
dc.contributor.authorCavassini, M.en_US
dc.contributor.authorFurrer, H.en_US
dc.contributor.authorDoco-Lecompte, T.en_US
dc.contributor.authorMarzolini, C.en_US
dc.contributor.authorSchmid, P.en_US
dc.contributor.authorDi Benedetto, C.en_US
dc.contributor.authorDecosterd, L. A.en_US
dc.contributor.authorFellay, J.en_US
dc.contributor.authorHubaux, Jean-Pierreen_US
dc.contributor.authorTelenti A.en_US
dc.date.accessioned2018-04-12T10:49:55Z
dc.date.available2018-04-12T10:49:55Z
dc.date.issued2016en_US
dc.identifier.issn1098-3600
dc.identifier.urihttp://hdl.handle.net/11693/36710
dc.description.abstractPurpose: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.Methods: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.Results: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%.Conclusions: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.en_US
dc.language.isoEnglishen_US
dc.source.titleGenetics in Medicineen_US
dc.relation.isversionofhttp://dx.doi.org/10.1038/gim.2015.167en_US
dc.subjectClinical genomicsen_US
dc.subjectEncryptionen_US
dc.subjectGenetic test reportingen_US
dc.subjectGenetic testingen_US
dc.subjectGenomic privacyen_US
dc.subjectDNAen_US
dc.subjectEfavirenzen_US
dc.subjectEtravirineen_US
dc.subjectHLA antigenen_US
dc.subjectLopinaviren_US
dc.subjectNevirapineen_US
dc.subjectAncestry groupen_US
dc.subjectFeasibility studyen_US
dc.subjectGenetic markeren_US
dc.subjectGenetic modelen_US
dc.subjectGenetic risken_US
dc.subjectGenetic screeningen_US
dc.subjectGenetic traiten_US
dc.subjectGenetic variabilityen_US
dc.subjectGenomicsen_US
dc.subjectGenotypeen_US
dc.subjectHealth care deliveryen_US
dc.subjectHealth care personnelen_US
dc.subjectHighly active antiretroviral therapyen_US
dc.subjectHumanen_US
dc.subjectHuman immunodeficiency virus infected patienten_US
dc.subjectHuman immunodeficiency virus infectionen_US
dc.subjectMajor clinical studyen_US
dc.subjectOutcome assessmenten_US
dc.subjectComputer securityen_US
dc.subjectEthicsen_US
dc.subjectGenetic variationen_US
dc.subjectTheoretical modelen_US
dc.subjectComputer securityen_US
dc.subjectHIV Infectionsen_US
dc.subjectHumansen_US
dc.subjectModelsen_US
dc.titlePrivacy-preserving genomic testing in the clinic: a model using HIV treatmenten_US
dc.typeArticleen_US
dc.departmentDepartment of Computer Engineering
dc.citation.spage814en_US
dc.citation.epage822en_US
dc.citation.volumeNumber18en_US
dc.citation.issueNumber8en_US
dc.identifier.doi10.1038/gim.2015.167en_US
dc.publisherNature Publishing Groupen_US


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