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

Of the 963 people enrolled, 857 completed the baseline assessment. Interferon-gamma release assays and standardized questionnaires were used to assess latent tuberculosis infection and collect participant characteristics. The baseline prevalence of infection was 6.8%, with a 95% confidence interval of 5.3% to 8.7%. The cohort was conducted in a setting described by the researchers as having a relatively low incidence of tuberculosis and HIV, and its stated aim was to examine a possible approach to tuberculosis screening and prevention in that context. It was an observational cohort study rather than a trial of screening, preventive treatment or another intervention.

The researchers used Firth’s penalized maximum likelihood logistic regression in univariable and multivariable analyses to address potential complete separation in the data. In the multivariable model, CD4 group was the only independent predictor of latent tuberculosis infection. Participants with CD4 counts below 400 cells per microliter had lower odds of infection than those with counts of at least 400 cells per microliter, with an adjusted odds ratio of 0.505, a 95% confidence interval of 0.258 to 0.929 and a P value of 0.027. This model estimate represents an association between baseline CD4 group and infection status; it does not show that changes in CD4 count caused latent tuberculosis infection.

Follow-up provided a separate estimate of assay conversion. Among the 554 participants who were negative by interferon-gamma release assay at baseline, 21 converted to positive, a proportion of 3.8% with a 95% confidence interval of 2.2% to 5.4%. The corresponding annual conversion rate was 1.75 per 100 person-years, with a 95% confidence interval of 1.09 to 2.68. These results describe conversions detected during follow-up rather than the precise time or mechanism of infection. One incident active tuberculosis case was identified, giving an incidence density of 0.084 cases per 100 person-years and a 95% confidence interval of 0.002 to 0.307. The very small number of active cases means the estimate of active-disease incidence is highly uncertain.

The findings provide local measurements of latent tuberculosis infection prevalence, conversion and active disease incidence among people living with HIV, as well as a model-based association between CD4 group and baseline infection status. They do not establish whether a strategy based on latent tuberculosis infection screening would prevent disease, improve clinical outcomes or be cost-effective. Important limitations include the restriction to two districts of one city, the incomplete baseline assessment among the 963 enrolled participants, the 554-person group available for conversion analysis and the occurrence of only one incident active tuberculosis case. The authors therefore described the results as preliminary and hypothesis-generating and said larger multicenter studies, extended follow-up and health-economic evaluations would be needed to determine whether a latent-tuberculosis-infection-guided approach could be viable in this low-burden context.

Subject of Research: Prospective cohort assessment of latent tuberculosis infection among people living with HIV in Shanghai

Article Title: Burden of latent tuberculosis infection among people living with HIV in Shanghai, China: a 4-year cohort study

Article References: Rao, L., Gu, K., Yang, Y., Le, B., Zhang, Z., Chen, J., Ning, Z., Yue, Q., Zhu, Z., & Shen, X. (2026). Burden of latent tuberculosis infection among people living with HIV in Shanghai, China: a 4-year cohort study. BMC Infectious Diseases. https://doi.org/10.1186/s12879-026-14178-6

Image Credits: AI Generated

DOI: 10.1186/s12879-026-14178-6

Keywords: latent tuberculosis, HIV, cohort study, Shanghai, IGRA, CD4 count, tuberculosis conversion, active tuberculosis, screening, Burden, latent, tuberculosis