Latent tuberculosis prevalence varies by registration status among people with HIV

A cross-sectional study found latent tuberculosis infection in 8.7% of 624 people living with HIV who were registered in the HIV follow-up management system in Linhai, a coastal city in eastern Zhejiang, China. Of these participants, 54 had positive interferon-gamma release assay, or IGRA, results after active tuberculosis had been excluded, corresponding to a prevalence of 8.7% with a 95% confidence interval of 6.4% to 10.9%. The analysis also identified associations between latent infection and age, household registration status, alkaline phosphatase level, and AIDS stage.

Researchers enrolled people living with HIV from the city’s HIV follow-up management system between January and December 2025. They defined latent tuberculosis infection as a positive IGRA result after excluding active tuberculosis. The cross-sectional design measured the prevalence of latent infection at the assessment and examined characteristics associated with a positive result. It could not determine whether any measured characteristic caused infection, and it did not examine the subsequent development of active tuberculosis.

Multivariable logistic regression showed that participants aged 50 years or older had higher adjusted odds of latent tuberculosis infection than those younger than 50, with an adjusted odds ratio of 1.89 and a 95% confidence interval of 1.02 to 3.51. Non-local household registration was associated with 2.81 times the adjusted odds, with a 95% confidence interval of 1.51 to 5.21. Elevated alkaline phosphatase was associated with 2.03 times the adjusted odds, with a 95% confidence interval of 1.03 to 4.02. Participants at the AIDS stage had lower odds than those not at that stage, with an adjusted odds ratio of 0.41 and a 95% confidence interval of 0.21 to 0.80. The authors said the lower positivity among participants at the AIDS stage may reflect reduced immune responsiveness, but the cross-sectional association does not establish that explanation. They also said the association with elevated alkaline phosphatase requires further investigation.

Participants with non-local household registration had a higher prevalence of latent tuberculosis infection, predominantly originated from regions with a high tuberculosis burden, and were mainly of working age. The findings identify household registration status as a correlate of latent infection in the studied population, rather than showing that migration itself caused the difference. Overall, the authors characterized the prevalence of latent tuberculosis infection among people living with HIV in eastern Zhejiang as generally low. The results were limited to 624 registered participants in Linhai and may not represent everyone living with HIV in the wider region. The study’s cross-sectional scope also prevents conclusions about changes over time, causation, or the risk of progression to active disease.

Subject of Research: Prevalence and associated factors of latent tuberculosis infection among people living with HIV in eastern Zhejiang, China

Article Title: Latent tuberculosis infection among people living with HIV in Eastern coastal China: prevalence, associated factors, and differences by household registration status

Article References: Zhang, Z., Zhou, L., Wang, F., Chen, X., Chen, R., Chen, L., Li, J., Zu, Z., & Chen, B. (2026). Latent tuberculosis infection among people living with HIV in Eastern coastal China: prevalence, associated factors, and differences by household registration status. BMC Infectious Diseases. https://doi.org/10.1186/s12879-026-14322-2

Image Credits: AI Generated

DOI: 10.1186/s12879-026-14322-2

Keywords: latent tuberculosis infection, HIV, tuberculosis, interferon-gamma release assay, household registration, Linhai, eastern Zhejiang, cross-sectional study, population mobility, public health, Latent, infection