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Faculty Profiles

John Metcalfe, MD, PhD, MPH
M_MED-PULM-ZSFG
Associate Professor

1001 Potrero Ave
San Francisco, CA 94110
415-596-9348
John.Metcalfe@ucsf.edu

John Z. Metcalfe, MD, PhD, MPH is an Associate Professor in the Division of Pulmonary and Critical Care Medicine. A consultant in pulmonary medicine and an intensivist at San Francisco General Hospital, Dr. Metcalfe has expertise in critical care and respiratory infectious diseases with a particular interest in clinical management of multidrug resistant tuberculosis (MDR-TB) in high HIV burden settings in Southern Africa. He also has expertise in development of non-invasive pharmacokinetic measures to enhance MDR-TB drug development and clinical trials. He is a member of the AIDS Clinical Trials Group TB Transformative Science Group, and has specialized training in epidemiology, statistical prediction, and diagnostic test evaluation. He is the specialty editor for respiratory diseases at PLoS Medicine.

Education and Training

Location Degree or Training Specialty Date
University of California, Berkely Ph.D. Division of Epidemiology 2012
University of California, San Francisco Fellowship Pulmonary and Critical Care Medicine 2009
University of California, San Francisco Residency Medicine 2006
Tufts University School of Medicine MPH Global Health 2003
Tufts University School of Medicine M.D. School of Medicine 2003
Humboldt State University BS Molecular Biology 1998
Michigan State University AB Sociology 1995

Awards and Honors

2015   Clinical Scientist Development Award, Doris Duke Charitable Foundation, 2015
2010   Harold Amos Scholar, Robert Wood Johnson Foundation, 2010
2008   Chancellor's Fellow, University of California, Berkeley, 2008

Related Web Sites

Recent Articles (44)

Metcalfe JZ, Streicher E, Theron G, Colman RE, Penaloza R, Allender C, Lemmer D, Warren RM, Engelthaler DM. Mycobacterium tuberculosis subculture results in loss of potentially clinically relevant heteroresistance. Antimicrob Agents Chemother. 2017 Sep 11.

Metcalfe J, Gerona R, Wen A, Bacchetti P, Gandhi M. An LC-MS/MS-based method to analyze the anti-tuberculosis drug bedaquiline in hair. Int J Tuberc Lung Dis. 2017 Sep 01; 21(9):1069-1070.

Chawana TD, Gandhi M, Nathoo K, Ngara B, Louie A, Horng H, Katzenstein D, Metcalfe J, Nhachi CFB. Defining a Cutoff for Atazanavir in Hair Samples Associated With Virological Failure Among Adolescents Failing Second-Line Antiretroviral Treatment. J Acquir Immune Defic Syndr. 2017 Sep 01; 76(1):55-59.

Metcalfe JZ, Streicher E, Theron G, Colman RE, Allender C, Lemmer D, Warren R, Engelthaler DM. Cryptic Micro-heteroresistance Explains M. tuberculosis Phenotypic Resistance. Am J Respir Crit Care Med. 2017 Jun 14.

O'Donnell MR, Padayatchi N, Metcalfe JZ. Elucidating the role of clofazimine for the treatment of tuberculosis. Int J Tuberc Lung Dis. 2016 Dec 01; 20(12):52-57.

Rylance J, Mchugh G, Metcalfe J, Mujuru H, Nathoo K, Wilmore S, Rowland-Jones S, Majonga E, Kranzer K, Ferrand RA. Chronic lung disease in HIV-infected children established on antiretroviral therapy. AIDS. 2016 Nov 28; 30(18):2795-2803.

Blount RJ, Tran MC, Everett CK, Cattamanchi A, Metcalfe JZ, Connor D, Miller CR, Grinsdale J, Higashi J, Nahid P. Tuberculosis progression rates in U.S. Immigrants following screening with interferon-gamma release assays. BMC Public Health. 2016 Aug 25; 16(1):875.

Moses MW, Zwerling A, Cattamanchi A, Denkinger CM, Banaei N, Kik SV, Metcalfe J, Pai M, Dowdy D. Serial testing for latent tuberculosis using QuantiFERON-TB Gold In-Tube: A Markov model. Sci Rep. 2016 Jul 29; 6:30781.

Metcalfe JZ, Makumbirofa S, Makamure B, Sandy C, Bara W, Mason P, Hopewell PC. Xpert(®) MTB/RIF detection of rifampin resistance and time to treatment initiation in Harare, Zimbabwe. Int J Tuberc Lung Dis. 2016 Jul; 20(7):882-9.

Gerona R, Wen A, Koss C, Bacchetti P, Gandhi M, Metcalfe J. A multi-analyte panel for non-invasive pharmacokinetic monitoring of second-line anti-tuberculosis drugs. Int J Tuberc Lung Dis. 2016 Jul; 20(7):991-2.

Gerona R, Wen A, Chin AT, Koss CA, Bacchetti P, Metcalfe J, Gandhi M. Quantifying Isoniazid Levels in Small Hair Samples: A Novel Method for Assessing Adherence during the Treatment of Latent and Active Tuberculosis. PLoS One. 2016; 11(5):e0155887.

O'Donnell MR, Daftary A, Frick M, Hirsch-Moverman Y, Amico KR, Senthilingam M, Wolf A, Metcalfe JZ, Isaakidis P, Davis JL, Zelnick JR, Brust JC, Naidu N, Garretson M, Bangsberg DR, Padayatchi N, Friedland G. Re-inventing adherence: toward a patient-centered model of care for drug-resistant tuberculosis and HIV. Int J Tuberc Lung Dis. 2016 Apr; 20(4):430-4.

Metcalfe JZ, O'Donnell MR, Bangsberg DR. Moving Beyond Directly Observed Therapy for Tuberculosis. PLoS Med. 2015 Sep; 12(9):e1001877.

Metcalfe JZ, Makumbirofa S, Makamure B, Mutetwa R, Peñaloza RA, Sandy C, Bara W, Mungofa S, Hopewell PC, Mason P. Suboptimal specificity of Xpert MTB/RIF among treatment-experienced patients. Eur Respir J. 2015 May; 45(5):1504-6.

Coscolla M, Barry PM, Oeltmann JE, Koshinsky H, Shaw T, Cilnis M, Posey J, Rose J, Weber T, Fofanov VY, Gagneux S, Kato-Maeda M, Metcalfe JZ. Genomic epidemiology of multidrug-resistant Mycobacterium tuberculosis during transcontinental spread. J Infect Dis. 2015 Jul 15; 212(2):302-10.

Metcalfe JZ, Vittinghoff E, Hopewell PC. Analysis of Green Light Committee implementation and acquisition of second-line drug resistance. Clin Infect Dis. 2015 Mar 15; 60(6):970.

Kelly JD, Grace Lin SY, Barry PM, Keh C, Higashi J, Metcalfe JZ. Xpert MTB/RIF false detection of rifampin-resistant tuberculosis from prior infection. Am J Respir Crit Care Med. 2014 Dec 01; 190(11):1316-8.

Tagmouti S, Slater M, Benedetti A, Kik SV, Banaei N, Cattamanchi A, Metcalfe J, Dowdy D, van Zyl Smit R, Dendukuri N, Pai M, Denkinger C. Reproducibility of interferon gamma (IFN-?) release Assays. A systematic review. Ann Am Thorac Soc. 2014 Oct; 11(8):1267-76.

Metcalfe JZ, Mason P, Mungofa S, Sandy C, Hopewell PC. Empiric tuberculosis treatment in retreatment patients in high HIV/tuberculosis-burden settings. Lancet Infect Dis. 2014 Sep; 14(9):794-5.

Mupfumi L, Makamure B, Chirehwa M, Sagonda T, Zinyowera S, Mason P, Metcalfe JZ, Mutetwa R. Impact of Xpert MTB/RIF on Antiretroviral Therapy-Associated Tuberculosis and Mortality: A Pragmatic Randomized Controlled Trial. Open Forum Infect Dis. 2014 Mar; 1(1):ofu038.

Davis JL, Kawamura LM, Chaisson LH, Grinsdale J, Benhammou J, Ho C, Babst A, Banouvong H, Metcalfe JZ, Pandori M, Hopewell PC, Cattamanchi A. Impact of GeneXpert MTB/RIF on patients and tuberculosis programs in a low-burden setting. a hypothetical trial. Am J Respir Crit Care Med. 2014 Jun 15; 189(12):1551-9.

Metcalfe JZ, Makumbirofa S, Makamure B, Sandy C, Bara W, Mungofa S, Hopewell PC, Mason P. Drug-resistant tuberculosis in high-risk groups, Zimbabwe. Emerg Infect Dis. 2014 Jan; 20(1):135-7.

Pai M, Denkinger CM, Kik SV, Rangaka MX, Zwerling A, Oxlade O, Metcalfe JZ, Cattamanchi A, Dowdy DW, Dheda K, Banaei N. Gamma interferon release assays for detection of Mycobacterium tuberculosis infection. Clin Microbiol Rev. 2014 Jan; 27(1):3-20.

Millman AJ, Dowdy DW, Miller CR, Brownell R, Metcalfe JZ, Cattamanchi A, Davis JL. Rapid molecular testing for TB to guide respiratory isolation in the U.S.: a cost-benefit analysis. PLoS One. 2013; 8(11):e79669.

Prach LM, Pascopella L, Barry PM, Flood J, Porco TC, Hopewell PC, Metcalfe JZ. Rifampin monoresistant tuberculosis and HIV comorbidity in California, 1993-2008: a retrospective cohort study. AIDS. 2013 Oct 23; 27(16):2615-22.

Cattamanchi A, Walter ND, Metcalfe JZ, Davis JL. A transcriptional signature for active TB: have we found the needle in the haystack? PLoS Med. 2013 Oct; 10(10):e1001539.

Gopal M, Padayatchi N, Metcalfe JZ, O'Donnell MR. Systematic review of clofazimine for the treatment of drug-resistant tuberculosis. Int J Tuberc Lung Dis. 2013 Aug; 17(8):1001-7.

Metcalfe JZ, Porco TC, Westenhouse J, Damesyn M, Facer M, Hill J, Xia Q, Watt JP, Hopewell PC, Flood J. Tuberculosis and HIV co-infection, California, USA, 1993–2008. Emerg Infect Dis. 2013 Mar; 19(3):400-6.

Makamure B, Mhaka J, Makumbirofa S, Mutetwa R, Mupfumi L, Mason P, Metcalfe JZ. Microscopic-observation drug-susceptibility assay for the diagnosis of drug-resistant tuberculosis in Harare, Zimbabwe. PLoS One. 2013; 8(2):e55872.

Metcalfe JZ, Cattamanchi A, McCulloch CE, Lew JD, Ha NP, Graviss EA. Test variability of the QuantiFERON-TB gold in-tube assay in clinical practice. Am J Respir Crit Care Med. 2013 Jan 15; 187(2):206-11.

Dantes R, Metcalfe J, Kim E, Kato-Maeda M, Hopewell PC, Kawamura M, Nahid P, Cattamanchi A. Impact of isoniazid resistance-conferring mutations on the clinical presentation of isoniazid monoresistant tuberculosis. PLoS One. 2012; 7(5):e37956.

Geng EH, Glidden DV, Bangsberg DR, Bwana MB, Musinguzi N, Nash D, Metcalfe JZ, Yiannoutsos CT, Martin JN, Petersen ML. A causal framework for understanding the effect of losses to follow-up on epidemiologic analyses in clinic-based cohorts: the case of HIV-infected patients on antiretroviral therapy in Africa. Am J Epidemiol. 2012 May 15; 175(10):1080-7.

Metcalfe JZ, Everett CK, Steingart KR, Cattamanchi A, Huang L, Hopewell PC, Pai M. Interferon-? release assays for active pulmonary tuberculosis diagnosis in adults in low- and middle-income countries: systematic review and meta-analysis. J Infect Dis. 2011 Nov 15; 204 Suppl 4:S1120-9.

Brust JC, O'Donnell MR, Metcalfe JZ. TB/HIV: an orphan disease? Am J Respir Crit Care Med. 2011 Jun 01; 183(11):1441-2.

Cattamanchi A, Smith R, Steingart KR, Metcalfe JZ, Date A, Coleman C, Marston BJ, Huang L, Hopewell PC, Pai M. Interferon-gamma release assays for the diagnosis of latent tuberculosis infection in HIV-infected individuals: a systematic review and meta-analysis. J Acquir Immune Defic Syndr. 2011 Mar 01; 56(3):230-8.

Kato-Maeda M, Metcalfe JZ, Flores L. Genotyping of Mycobacterium tuberculosis: application in epidemiologic studies. Future Microbiol. 2011 Feb; 6(2):203-16.

Metcalfe JZ, Kim EY, Lin SY, Cattamanchi A, Oh P, Flood J, Hopewell PC, Kato-Maeda M. Determinants of multidrug-resistant tuberculosis clusters, California, USA, 2004-2007. Emerg Infect Dis. 2010 Sep; 16(9):1403-9.

Davis JL, Worodria W, Kisembo H, Metcalfe JZ, Cattamanchi A, Kawooya M, Kyeyune R, den Boon S, Powell K, Okello R, Yoo S, Huang L. Clinical and radiographic factors do not accurately diagnose smear-negative tuberculosis in HIV-infected inpatients in Uganda: a cross-sectional study. PLoS One. 2010 Mar 26; 5(3):e9859.

Metcalfe JZ, Cattamanchi A, Vittinghoff E, Ho C, Grinsdale J, Hopewell PC, Kawamura LM, Nahid P. Evaluation of quantitative IFN-gamma response for risk stratification of active tuberculosis suspects. Am J Respir Crit Care Med. 2010 Jan 01; 181(1):87-93.

Cattamanchi A, Dantes RB, Metcalfe JZ, Jarlsberg LG, Grinsdale J, Kawamura LM, Osmond D, Hopewell PC, Nahid P. Clinical characteristics and treatment outcomes of patients with isoniazid-monoresistant tuberculosis. Clin Infect Dis. 2009 Jan 15; 48(2):179-85.

Gouveia EL, Metcalfe J, de Carvalho AL, Aires TS, Villasboas-Bisneto JC, Queirroz A, Santos AC, Salgado K, Reis MG, Ko AI. Leptospirosis-associated severe pulmonary hemorrhagic syndrome, Salvador, Brazil. Emerg Infect Dis. 2008 Mar; 14(3):505-8.

Roshanravan B, Kari E, Gilman RH, Cabrera L, Lee E, Metcalfe J, Calderon M, Lescano AG, Montenegro SH, Calampa C, Vinetz JM. Endemic malaria in the Peruvian Amazon region of Iquitos. Am J Trop Med Hyg. 2003 Jul; 69(1):45-52.

Stephanie Margaret Selike Wilmore, MRCP, MSc; Katharina Kranzer; Alan Williams; Beauty Makamure; Agness Nhdiza; Justin Mayini; Tsitsi Bandason; John Metcalfe; Mark Nicol; Indran Balakrishnan; Matthew Ellington; Neil Woodford; Susan Hopkins; Tim D McHugh; Rashida Ferrand. . Carriage of Extended-Spectrum Beta-Lactamase-producing Enterobacteriaceae in HIV-infected children in Zimbabwe. Accepted, Journal of Medical Microbiology.

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