Center for AIDS Research

Dr. James C.M. Brust

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South Africa

Dr. Brust is Assistant Professor of Medicine (General Internal Medicine & Infectious Diseases) and his research focuses on the dual epidemics of drug-resistant tuberculosis and HIV in the province of KwaZulu-Natal, South Africa. He is involved in several studies targeting different aspects of the epidemic. A better understanding of the epidemiology, treatment outcomes, and operational challenges is critical to gaining control of these devastating, synergistic diseases.

Integrated, home-based treatment for MDR TB and HIV
Dr. Brust and his colleagues have worked closely with a local NGO and the Department of Health to design and implement a decentralized, and integrated, home-based treatment program for patients with MDR TB and HIV in a rural, resource-limited area of KwaZulu-Natal. Dr. Brust has an NIH-funded grant to evaluate the effectiveness and safety of this program.

MDR TB and HIV Co-Infection
Working with Dr. Neel Gandhi at Emory (PI) and the South African Medical Research Council, Dr. Brust is co-investigator on a study examining the interplay of TB drug-resistance and HIV. The SHOUT (Survival and HIV OUTcomes in MDR TB) is a three-arm, prospective cohort, enrolling patients with MDR TB and HIV, MDR TB without HIV, and drug-susceptible TB with HIV. Following the patients for several years, the study will examine the effect of antiretroviral therapy on MDR TB treatment outcomes, the effect of TB drug-resistance and MDR TB treatment on HIV outcomes, as well as the effect of strain differences on outcomes throughout the province. The research team includes Dr. Barry Kreiswirth at UMDNJ’s Public Health Research Institute.

Extensively Drug-Resistant TB (XDR TB) Transmission
Also with Dr. Neel Gandhi at Emory, the South African Medical Research Council, and Dr. Sarita Shah at CDC, Dr. Brust is co-investigator on the TRAX study (TRAnsmission of XDR TB), which enrolls patients with XDR TB throughout KwaZulu-Natal using social network analysis as well as molecular epidemiologic techniques to identify and understand patterns of transmission.

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