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. The UCSF Center for Tuberculosis (https://tb.ucsf.edu) was established in the Division of Pulmonary and Critical Care Medicine to support TB research, training, and clinical activities across UCSF. In 2024, it moved to the Institute for Global Health Sciences (IGHS) to expand its reach and coordination across all UCSF Schools. It includes the CDC-funded Curry International Tuberculosis Center (https://www.currytbcenter.ucsf.edu/), which provides nationwide training and technical assistance, and also serves as the operational hub for the NIH-funded UC Tuberculosis Research Advancement Center (UC TRAC) (https://tb.ucsf.edu/uc-trac), supporting early-career and new-to-TB investigators at UCSF and UC Berkeley.

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 TrialsTB figure

  • 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)

Clinical and 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)

  • A prospective cohort study in Kampala, Uganda of heart and lung conditions after TB in persons with and without HIV, which examines HIV as an effect modifier for the observed cardiopulmonary phenotypes (Huang)

  • A prospective cohort study in Kampala, Uganda of post-TB lung disease (PTLD), studying the synergistic effects of sex, HIV, and air pollution on PTLD (Huang)

Bench Research


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HIV/AIDS-associated Lung Disease

Clinical and Translational Research

  • A longitudinal cohort of HIV+ individuals in the US and Uganda, studying the roles of HIV and pneumonia on COPD and diffusion abnormalities, including an isolated reduction in the diffusing capacity for carbon monoxide (Huang)

Translational and Bench Research

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Global Lung Health

Figure 2Clinical Trials

  • Randomized controlled trial in rural Rwanda of a combined clean cooking and lighting intervention on growth of lung function in children and on decline of lung function in adults (Balmes)

Clinical Studies

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Clinical and Translational Research

  • A prospective cohort study in Kampala, Uganda of heart and lung conditions after TB in persons with and without HIV, which examines HIV as an effect modifier for the observed cardiopulmonary phenotypes (Huang).​​​

  • A prospective cohort study in Kampala, Uganda of post-TB lung disease (PTLD), studying the synergistic effects of sex, HIV, and air pollution on PTLD (Huang).

  • A longitudinal cohort of HIV+ individuals in the US and Uganda, studying the roles of HIV and pneumonia on COPD and diffusion abnormalities, including an isolated reduction in the diffusing capacity for carbon monoxide (Huang)
Faculty