Objective: To identify host factors associated with false-negative results of interferon-? release tests in adults with active tuberculosis.Methods: The clinical data of 909 patients with active tuberculosis diagnosed by acid-fast smear staining, Mycobacterium tuberculosis culture, mycobacterium tuberculosis PCR and pathological examination at West China Hospital of Sichuan University were retrospectively analyzed. They were divided into the IGRA^- group and IGRA⁺ group. Logistic regression was used to analyze the sociodemographic data and clinical characteristics of participants in the IGRA^-group and IGRA⁺ group.Results: Among 909 patients with active tuberculosis, 169 (18.6%) were IGRA negative (false negative), and 740 (81.4%) were IGRA positive. Multivariate logistic regression analysis identified the following characteristics independently associated with IGRA negativity: older age (OR: 1.02; 95% CI: 1.01 1.03; p =0.003), anti-tuberculosis treatment > 1 month (OR: 0.66; 95% CI: 0.44 0.99; p =0.042), HIV infection (OR: 0.07; 95% CI: 0.02 0.25; p = 0.000), combined with connective tissue diseases (OR: 0.34; 95% CI: 0.16 0.73; p =0.005) and low hemoglobin (OR: 0.99; 95% CI: 0.98 1.00; p =0.009) was associated with an increased false-negative probability of IGRA.Conclusion: Older age, anti-tuberculosis therapy > 1 month, coinfection with HIV, coassociated connective tissue disease and decreased hemoglobin were identified as risk factors for false-negative results of false IGRA. Our results suggest a careful interpretation of IGRA in adults with these characteristics.