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Faculty Profile

James C.M. Brust, M.D.

Dr. James C.M. Brust

Associate Professor, Department of Medicine (General Internal Medicine)


Professional Interests

Dr. Brust is an Assistant Professor in the Department of Medicine, with joint appointments in the Divisions of General Internal Medicine and Infectious Diseases. He graduated from College of Physicians & Surgeons at Columbia University and completed both a residency in Internal Medicine and a fellowship in Infectious Diseases at the Columbia University Medical Center. 

Dr. Brust's research has focused on the dual epidemics of multidrug-resistant tuberculosis (MDR TB) and HIV in KwaZulu-Natal (KZN), South Africa.  He designed and implemented a novel, home-based treatment program for patients co-infected with HIV and MDR TB and was awarded a K23 Career Development grant from the NIAID to study the program. With collaborators at Emory University, CDC, PHRI-Rutgers and the University of KwaZulu-Natal, he has been defining and examining responses to the epidemic in KZN. He was recently awarded an R01 from NIAID to study the new TB medication, bedaquiline in patients with extensively drug-resistant (XDR) TB--specifically to define the genetic mechanisms of resistance and drug-drug interactions with antiretroviral therapy as the drug is rolled out in South Africa. 

Current Investigations

  1. Safety, pharmacokinetics and mechansisms of resistance to bedaquiline in XDR TB and HIV (PI)
  2. Integrated, home-based treatment for MDR TB and HIV in rural South Africa (PI)
  3. Prospective cohort of MDR TB patients with and without HIV co-infection (Co-I)
  4. Molecular epidemiology of multidrug- and extensively drug-resistant tuberculosis in KwaZulu-Natal, South Africa (Co-I)

Selected Publications

Brust JCM, Gandhi NR, Carrara H, Osburn G and Padayatchi N. High Treatment Failure and Default Rates for Patients with MDR TB in KwaZulu-Natal, South Africa, 2000-2003. Int J Tuberc Lung Dis. 2010;14(4):413-9

Brust JCM, Lygizos M, Chaiyachati K, Scott, M, van der Merwe TL, Moll AP, Li X, Loveday M, Bamber S, Lalloo UG, Friedland GH, Shah NS, and Gandhi NR. Culture conversion among HIV co-infected multidrug-resistant tuberculosis patients in Tugela Ferry, South Africa. PLoS One 6(1): e15841. doi:10.1371/journal.pone.0015841


Brust JCM, Litwin AH, Berg KM, Li X, Heo M, and Arnsten JH. Directly observed antiretroviral therapy in substance abusers receiving methadone maintenance therapy does not cause increased drug resistance. AIDS Res Hum Retroviruses. 2011; 27(5):535-41


Brust JCM, O’Donnell MR, and Metcalfe JZ. TB/HIV: An orphan disease? Am J Resp Crit Care Med. 2011; 183:1441-2


Gandhi NR, Andrews JR, Brust JCM, Montreuil R, Weissman D, Heo M, Moll AP, Friedland GH, Shah NS. Risk factors for mortality among MDR- and XDR-TB patients in a high HIV-prevalence setting. Int J Tuberc Lung Dis. 2012; 16(1):90-97

Brust JCM, Shah NS, Scott M, Chaiyachati K, Lygizos M, van der Merwe TL, Bamber S, Radebe Z, Loveday M, Moll AP, Margot B, Lalloo UG, Friedland GH, Gandhi NR. Integrated, home-based treatment for MDR-TB and HIV in rural South Africa: an alternate model of care. Int J Tuberc Lung Dis 2012; 16:998-1004.

Brust JCM, Shah NS, van der Merwe TL, Bamber S, Ning Y, Heo M, Moll AP, Loveday M, Lalloo UG, Friedland GH, Gandhi NR. Adverse events in an integrated, home-based treatment program for MDR-TB and HIV in KwaZulu-Natal, South Africa. J Acquir Immune Defic Syndr 2013; 62:436-440.

Brust JCM, Berman AR, Zalta B, Haramati LB, Ning Y, Heo H, van der Merwe TL, Bamber S, Moll AP, Friedland GH, Shah NS, Gandhi NR.Chest radiograph findings and time to culture conversion in patients with multidrug-resistant tuberculosis and HIV in Tugela Ferry, South Africa.PLoS One 2013; 8(9): e73975. doi:10.1371/journal.pone.0073975


Gandhi NR, Brust JCM, Moodley P, Weissman D, Heo M, Ning Y, Moll AP, Friedland GH, Sturm W, Shah NS. Low M. tuberculosis strain diversity among multidrug- and extensively drug-resistant tuberculosis isolates from Tugela Ferry, South Africa, 2005-2006. Emerg Infect Dis 2014; 20(3):394-401.


Loveday M, Padayatchi N, Wallengren K, Roberts J, Brust J, Ngozo J, Master I, Voce A. Association between health systems performance and treatment outcomes in patients co-infected with MDR-TB and HIV in KwaZulu-Natal, South Africa: Implications for TB programmes. PLoS ONE 2014 9(4): e94016. doi:10.1371/journal.pone.0094016


Loveday M, Wallengren K, Brust J, Roberts J, Voce A, Margot B, Ngozo J, Master I, Cassell G, Padayatchi N. Community-based care vs. centralised hospitalisation for MDR-TB patients, KwaZulu-Natal, South Africa. Int J Tuberc Lung Dis. 2015 Feb;19(2):163-71. 





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