About

Gregory P Bisson, MD, MSCE, is an Associate Professor of Medicine (Infectious Diseases) and a Senior Scholar in the Department of Biostatistics and Epidemiology at the Perelman School of Medicine, University of Pennsylvania. His educational background includes a BA in Japanese Language and Literature from the University of Wisconsin-Madison, an MD from the University of Minnesota School of Medicine, and an MSCE in Epidemiology from the Perelman School of Medicine at the University of Pennsylvania. His research is dedicated to improving treatment outcomes for patients with HIV and tuberculosis (TB) and other AIDS-associated opportunistic infections. His current projects evaluate the relationship between early virologic and immunologic responses to antiretroviral therapy and clinical outcomes in adults with HIV/TB, with a focus on understanding the pathophysiologic and social mechanisms underlying early deaths in patients with advanced HIV. Additionally, he pursues translational research on host-directed therapies for drug-resistant TB. His work includes defining post-tuberculosis lung disease, assessing comorbidities and risk factors, and exploring novel imaging techniques for TB, contributing significantly to the field of infectious diseases and epidemiology.

Research topics

• Medicine
• Internal medicine
• Immunology
• Virology
• Pharmacology

Selected publications

• Inflammatory profiles in sputum and blood of people with TB with and without HIV coinfection

  Tuberculosis · 2025-01-31 · 1 citations

  articleSenior author
  PublisherDOI

• The impact of COVID-19 and public health measures on homicide and suicide trends in Botswana using an interrupted time series analysis

  Injury Epidemiology · 2025-07-21 · 1 citations

  articleOpen accessSenior author

  INTRODUCTION: The effects of the COVID-19 pandemic and subsequent public health measures on trends of homicide and suicide in various settings remain unclear. There has been little attention paid to the effects of the COVID-19 pandemic on trends of homicide and suicide in African countries. METHODS: We conducted an interrupted time-series analysis (ITSA) to evaluate the impact of the COVID-19 pandemic on monthly homicide and suicide trends in Botswana. Using forensic registers from the Forensic Pathology Unit of the Botswana Police Service, we compared mean incidence and trends before, during, and after the State of Emergency (SoE), stratifying by age and sex. RESULTS: Our study analyzed 2,225 autopsies from January 1, 2018, to September 30, 2022, comprising of 1,479 homicides and 746 suicides. Monthly autopsy rates were lower during the SoE (median 32, IQR: 11.5) compared to pre-SoE (40, IQR: 15.8) and post-SoE (46, IQR: 11.5) periods. Homicide rates were 28 (IQR: 7.5), 19 (IQR: 7), and 29.5 (IQR: 10) for pre-SoE, SoE, and post-SoE, respectively, while suicide rates were 12.5 (IQR: 4), 13 (IQR: 6), and 16.5 (IQR: 4.75). CONCLUSIONS: Our findings indicate a reduction in homicide and suicide incidence during the SoE, with a return to pre-pandemic levels thereafter. Public health professionals can leverage these insights to identify actionable factors for reducing suicide and homicide risks in future crises.

  PublisherOA PDFDOI

• Assessment of comorbidities, risk factors, and post tuberculosis lung disease in National Tuberculosis Guidelines: A scoping review

  PLOS Global Public Health · 2025-07-23 · 3 citations

  reviewOpen accessCorresponding

  Tuberculosis (TB) remains a major public health issue across the world and national TB guidelines are an important resource for diagnosis and treatment. This scoping review aimed to analyze how countries with the highest TB burdens approach the integration of comorbidity and risk factor screening, diagnosis and treatment, TB recurrence, and post-TB lung disease (PTLD) diagnosis and management, within their TB guidelines. We used the Arksey and O'Malley methodological framework to conduct a scoping review of TB guidelines among the WHO list of highest-TB burden countries. We identified drug-susceptible, drug-resistant, and consolidated guidelines through web searches and personal contacts within TB programs. We translated guidelines into English as needed and systematically extracted, recorded, and reviewed the guidelines to aggregate and describe our findings. Among the 49 countries with the highest TB burden, we successfully identified, translated, and analyzed 43 guidelines (24 drug-sensitive, 9 drug-resistance, and 10 consolidated) from 34 countries. Recommendations for screening varied by comorbidity or risk factor with the four most recommended being HIV/AIDS (100%), pregnancy (73%) and liver disease (59%) and mental health (59%). Recommendations for linkage to care were more infrequent and also varied with the top four being HIV (88%), liver disease (47%), diabetes (44%), and mental health (44%). Only 27 (79%) countries specified diagnostic tests to assess for TB recurrence among individuals presenting with symptoms post-TB treatment, with 25 recommending GeneXpert MTB/RIF. Notably, only 7 (21%) countries mentioned PTLD in their guidelines, with wide variations in their specific recommendations regarding screening, diagnosis, and management. Our findings highlight the lack of detailed guidance on how to properly diagnose and refer patients to appropriate care for various comorbidities or risk factors which may significantly impact microbiological and clinical TB treatment outcomes, including PTLD and ultimately point to an important opportunity for improvement in future guidelines.

  PublisherDOI

• Post-tuberculosis Sequelae and the Burden of “Long TB”: Continuing TB Care after Treatment Completion

  American Journal of Respiratory and Critical Care Medicine · 2025-04-30 · 2 citations

  letterOpen accessSenior author
  PublisherOA PDFDOI

• Collagen-targeted PET/CT imaging of tuberculosis patients

  European Respiratory Journal · 2025-07-01

  letterOpen accessSenior author

  <title>Extract</title> In addition to being the leading cause of death from a single infectious disease, tuberculosis (TB) causes chronic respiratory sequelae, including impaired lung function, in over 50% of TB survivors [1, 2]. Pulmonary TB results in fibrosis and cavitation in up to 84% and 70% of patients after treatment completion, respectively [3]. TB-associated lung damage involves extra-cellular matrix breakdown by host matrix metalloproteinases (MMPs) that degrade lung collagen [4, 5]. Despite its relevance to disease pathogenesis and patient outcomes, limited data on matrix remodeling during active TB are available in humans. Higher levels of airway MMP-1 and MMP-2 correlate with pulmonary cavitation [6], and a small randomized trial found that using the MMP inhibitor doxycycline during TB treatment was associated with decreased cavity volume [7]. Therefore, host-directed therapies (HDTs) modifying matrix remodeling and aberrant fibrosis could improve post-TB outcomes. However, such interventions would likely be most successful in patients presenting with greater profibrotic activity and collagen deposition.

  PublisherOA PDFDOI

• Relapse and Emergent Resistance With Novel Short-Course Regimens for Multidrug-Resistant Tuberculosis, United States, 2022–2024

  Open Forum Infectious Diseases · 2025-12-26 · 1 citations

  articleOpen access

  Abstract Background Bedaquiline, pretomanid, and linezolid with or without moxifloxacin (BPaL/M) are recommended oral 6-month treatment regimens for multidrug- or rifampin-resistant (MDR/RR) tuberculosis (TB). Since the US rollout of these regimens in 2019, the US Centers for Disease Control and Prevention (CDC) and partners have identified patients who failed or relapsed on these regimens. Methods Here, we report a case series of US patients with TB treated with BPaL/M-containing regimens, who experienced adverse outcomes during the period 2022‒2024, including drug resistance, relapse, and treatment failure. Results Clinical and public health outcomes were significant for US patients reported. There were 8 patients identified (n = 8). 5 (62.5%) were male, with a median age 57 years, 2 (25%) were previously treated for TB, and 8 (100%) presented with cavitary disease. This included a patient who died from infectious TB with acquired resistance after exposing over 100 healthcare workers, a waitress who was found to have highly infectious TB at the time of her relapse, and a son who contracted Mycobacterium tuberculosis (Mtb) with reduced activity to bedaquiline from his mother in a household transmission event. Conclusions These patients highlight consequences, both for the individual and public health, of relapse and treatment failure in real-life operational settings that may not be readily evident in well-controlled and well-resourced clinical trials. Despite the advent of shorter and better tolerated bedaquiline-based regimens, US clinicians continue to face challenges in managing drug-resistant TB. These data support the need for expert management of these patients beyond routine TB care, as well as the need for close monitoring and follow-up months after treatment completion.

  PublisherDOI

• Post-tuberculosis lung disease: towards prevention, diagnosis, and care

  The Lancet Respiratory Medicine · 2025-03-22 · 25 citations

  reviewOpen access
  PublisherOA PDFDOI

• HIV COINFECTION IS ASSOCIATED WITH LOWER ODDS OF OBSTRUCTIVE LUNG DISEASE AT THE TIME OF PULMONARY TUBERCULOSIS DIAGNOSIS

  CHEST Journal · 2025-10-01

  articleOpen access
  PublisherOA PDFDOI

• Post-tuberculosis lung disease: a case definition for use in research studies

  The Lancet Infectious Diseases · 2025-11-01 · 4 citations

  review1st authorCorresponding
  PublisherDOI

• Inflammatory profiles in sputum and blood of people with TB with and without HIV coinfection

  medRxiv · 2024-04-24 · 1 citations

  preprintOpen accessSenior author

  Although tuberculosis (TB) remains a major killer among infectious diseases and the leading cause of death for people with HIV, drivers of immunopathology, particularly at the site of infection in the lungs remain incompletely understood. To fill this gap, we compared cytokine profiles in paired plasma and sputum samples collected from adults with pulmonary TB with and without HIV. We found that people with pulmonary TB with HIV had significantly higher markers of inflammation in both plasma and sputum than those without HIV; these differences were present despite a similar extent of radiographic involvement. We also found that the strength and direction of correlations between biomarkers in the blood and lung compartments differed by HIV status and people with HIV had more positive correlations than those without HIV. Future studies can further explore these differences in inflammation by HIV status across the blood and lung compartments and seek to establish how these profiles may be associated with long-term outcomes and lung health after completion of TB treatment.

  PublisherOA PDFDOI

Recent grants

• NIH Grant K23AI058881

  NIH · $662k · 2009

• NIH Grant R01AI080337

  NIH · $3.5M · 2015

• Rapid Immune Restoration and Lung Injury in HIV/TB

  NIH · $3.3M · 2015–2022

• Inflammation and Fibrosis in Pulmonary TB: the INFIN-TB Study

  NIH · $4.2M · 2022–2027

Frequent coauthors

• Andrew P. Steenhoff

  Children's Hospital of Philadelphia

  69 shared

• Robert Gross

  55 shared

• Shruthi Ravimohan

  Bristol-Myers Squibb (United States)

  45 shared

• Drew Weissman

  University of Pennsylvania

  42 shared

• Scarlett L. Bellamy

  Boston University

  23 shared

• Neo Tamuhla

  Botswana Open University

  21 shared

• Amita Gupta

  Johns Hopkins Medicine

  19 shared

• Kogieleum Naidoo

  Centre for the AIDS Programme of Research in South Africa

  17 shared

Labs

• Gregory P Bisson LabPI