Infection/Global Health

ZSFG San Francisco General Hospital (SFGH), now Zuckerberg San Francisco General Hospital and Trauma Center (ZSFG), has a long history as a leading center in caring for tuberculosis (TB) patients, dating back to its days as a TB sanatorium and later hospital in the 19th and early 20th centuries. UCSF is home to the Curry International Tuberculosis Center and is also part of the CDC’s Tuberculosis Trials Consortium (TBTC). In 2019, UCSF established the UCSF Center for Tuberculosis (https://tb.ucsf.edu) to integrate and enhance collaboration opportunities for the collective of faculty, fellows and trainees involved in TB activities across UCSF schools, departments and programs.

Since the earliest days of the HIV/AIDS epidemic, SFGH/ZSFG and UCSF have been at the forefront of many of the leading studies on the epidemiology, presentation, diagnosis, treatment, and critical care of HIV-associated opportunistic pneumonias, most prominently Pneumocystis pneumonia (PCP). As persons living with HIV are now living longer, these studies have expanded to include HIV-associated chronic obstructive pulmonary disease (COPD), the most frequent chronic lung condition in persons living with HIV/AIDS.

Worldwide, 95% of the world’s population live in areas that exceed WHO guidelines for health air. People who use solid, biomass fuels (wood, coal) for cooking and heating are at especially high risk for both infectious (pneumonia) and non-infectious (COPD, lung cancer) lung complications.

Division faculty are conducting a broad spectrum of research in TB, HIV/AIDS, and global lung health.

Tuberculosis (TB)

Clinical Trials

Stepped-wedge randomized trial of 99DOTS (a digital adherence technology) for improving TB treatment completion rates at TB treatment units in Uganda (Cattamanchi)
Cluster-randomized trial of a multi-component health systems intervention including onsite molecular testing using GeneXpert Edge/Omni platforms to increase TB diagnosis and treatment initiation at community health centers in Uganda (Cattamanchi)
Randomized trial of directly-observed therapy (DOT) vs. self-administered therapy (SAT) with digital adherence monitoring and support vs. patient choice between DOT and SAT for completion of short-course TB preventive therapy in the context of routine HIV/AIDS care in Uganda (Cattamanchi)
Stepped-wedge randomized trial of cash transfers plus social support to support completion of TB diagnostic evaluation in community health centers in Uganda (Shete)

Clinical Studies

Clinical management of highly drug resistant TB through early individualized treatment regimens and prompt reassessment of ineffective treatments utilizing technically modern but pragmatic tools integrated within a variety of national program settings (Metcalfe)

Translational Research

Targeted and whole genome sequencing to quantify the impact of hetero-resistance on treatment outcomes for drug-resistant TB and to identify novel mutations associated with resistance to second-line anti-TB drugs in the Philippines (Kato-Maeda and Cattamanchi)
Active community-wide screening to identify every detectable TB case in a well-circumscribed urban Ugandan district and use of whole genome sequencing to detect transmission networks in the community to identify specific targeted interventions that could diagnose and treat that TB sooner (Kato-Maeda)
Epidemiologic and economic modeling of TB and LTBI public health strategies (Shete)

Bench Research

Assessing the impact of anti-TB drug regimens on the anatomic heterogeneity of Mycobacterium tuberculosis (Mtb) growth (Vásquez)
Defining mechanisms of Mtb control and persistence in pulmonary myeloid cells (Vásquez)

HIV/AIDS-associated Lung Disease

Clinical and Translational Research

Longitudinal cohort of HIV+ individuals with COPD in the US (Huang)

Translational and Bench Research

Understanding the role of pulmonary myeloid cell dysfunction in HIV-associated lung disease (Vásquez)

Global Lung Health