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

In eastern coastal China, with high population mobility, individuals with HIV/AIDS are at elevated risk of tuberculosis (TB). Understanding the epidemiology of latent TB infection (LTBI) in this population is important to tailor prevention strategies. This study examines LTBI prevalence and its associated factors among people living with HIV in Eastern Zhejiang, China. We conducted a cross-sectional study among people living with HIV who were registered in the HIV follow-up management system in Linhai, a coastal city in Eastern Zhejiang, China, between January and December 2025. LTBI was defined as a positive interferon-γ release assay (IGRA) result after active tuberculosis had been excluded. Associated factors were examined using multivariable logistic regression. A total of 624 participants were included, of whom 54 had positive IGRA results, indicating an LTBI prevalence of 8.7% (95% confidence interval [CI], 6.4–10.9). LTBI was associated with age ≥ 50 years (adjusted odds ratio [aOR], 1.89; 95% CI, 1.02–3.51), non-local household registration (aOR, 2.81; 95% CI, 1.51–5.21), elevated alkaline phosphatase (aOR, 2.03; 95% CI, 1.03–4.02), and AIDS stage (aOR, 0.41; 95% CI, 0.21–0.80). Participants with non-local household registration predominantly originated from regions with a high TB burden, exhibited a higher LTBI prevalence, and were predominantly of working age. The prevalence of LTBI among people living with HIV in eastern Zhejiang was generally low. Older age and non-local household registration were associated with LTBI. Lower positivity among participants with AIDS may reflect reduced immune responsiveness. The association with elevated alkaline phosphatase requires further investigation.