diff --git a/pyhealth/metrics/regression.py b/pyhealth/metrics/regression.py
index 2d0d02ed5..094b21ab1 100644
--- a/pyhealth/metrics/regression.py
+++ b/pyhealth/metrics/regression.py
@@ -51,11 +51,10 @@ def regression_metrics_fn(
     output = {}
     for metric in metrics:
         if metric == "kl_divergence":
-            # Work on copies to avoid mutating x/x_rec for subsequent metrics
-            x_kl = x.copy()
-            x_rec_kl = x_rec.copy()
-            x_kl[x_kl < 1e-6] = 1e-6
-            x_rec_kl[x_rec_kl < 1e-6] = 1e-6
+            # Clip into copies without truncating the floor for integer inputs.
+            # Keep x/x_rec unchanged for subsequent metrics.
+            x_kl = np.clip(x, 1e-6, None)
+            x_rec_kl = np.clip(x_rec, 1e-6, None)
             x_kl = x_kl / np.sum(x_kl)
             x_rec_kl = x_rec_kl / np.sum(x_rec_kl)
             kl_divergence = np.sum(x_rec_kl * np.log(x_rec_kl / x_kl))
diff --git a/tests/core/test_regression_integer_kl.py b/tests/core/test_regression_integer_kl.py
new file mode 100644
index 000000000..7dee8b3e4
--- /dev/null
+++ b/tests/core/test_regression_integer_kl.py
@@ -0,0 +1,86 @@
+"""Regression tests for KL divergence on integer-valued arrays.
+
+Author: Pema Sangpo Lama
+Description: Exercise zero clipping using tiny synthetic count arrays.
+"""
+
+import math
+import unittest
+
+import numpy as np
+
+from pyhealth.metrics import regression_metrics_fn, timeseries_regression_metrics_fn
+
+
+class TestIntegerKLDivergence(unittest.TestCase):
+    def setUp(self):
+        # KL([1, eps] / (1 + eps) || [eps, 1] / (1 + eps)).
+        eps = 1e-6
+        self.expected = (1 - eps) / (1 + eps) * math.log(1 / eps)
+
+    def test_zero_counts_are_clipped_in_either_input(self):
+        for dtype in (np.int32, np.int64, np.uint64):
+            for integer_target, integer_prediction in (
+                (True, False),
+                (False, True),
+                (True, True),
+            ):
+                with self.subTest(
+                    dtype=dtype, target=integer_target, prediction=integer_prediction
+                ):
+                    x = np.array([0, 1], dtype=dtype if integer_target else float)
+                    x_rec = np.array(
+                        [1, 0], dtype=dtype if integer_prediction else float
+                    )
+                    with np.errstate(divide="raise", invalid="raise"):
+                        result = regression_metrics_fn(x, x_rec, ["kl_divergence"])
+                    self.assertAlmostEqual(result["kl_divergence"], self.expected)
+
+    def test_all_zero_integer_inputs_give_zero_divergence(self):
+        for dtype in (np.int32, np.int64, np.uint64):
+            with self.subTest(dtype=dtype):
+                with np.errstate(divide="raise", invalid="raise"):
+                    result = regression_metrics_fn(
+                        np.zeros(2, dtype=dtype),
+                        np.zeros(2, dtype=dtype),
+                        ["kl_divergence"],
+                    )
+                self.assertEqual(result["kl_divergence"], 0.0)
+
+    def test_floating_point_inputs_still_match_clipped_divergence(self):
+        for dtype, places in ((np.float32, 5), (np.float64, 7)):
+            with self.subTest(dtype=dtype):
+                result = regression_metrics_fn(
+                    np.array([0, 1], dtype=dtype),
+                    np.array([1, 0], dtype=dtype),
+                    ["kl_divergence"],
+                )
+                self.assertAlmostEqual(result["kl_divergence"], self.expected, places)
+
+    def test_other_metrics_and_inputs_keep_original_values(self):
+        x = np.array([0, 1], dtype=np.int64)
+        x_rec = np.array([1, 0], dtype=np.int64)
+        for metrics in (None, ["mse", "mae", "kl_divergence"]):
+            with self.subTest(metrics=metrics):
+                with np.errstate(divide="raise", invalid="raise"):
+                    result = regression_metrics_fn(x, x_rec, metrics)
+                self.assertAlmostEqual(result["kl_divergence"], self.expected)
+                self.assertEqual(result["mse"], 1.0)
+                self.assertEqual(result["mae"], 1.0)
+                np.testing.assert_array_equal(x, [0, 1])
+                np.testing.assert_array_equal(x_rec, [1, 0])
+                self.assertEqual(x.dtype, np.dtype(np.int64))
+                self.assertEqual(x_rec.dtype, np.dtype(np.int64))
+
+    def test_timeseries_integer_counts_use_safe_clipping(self):
+        with np.errstate(divide="raise", invalid="raise"):
+            result = timeseries_regression_metrics_fn(
+                [np.array([0]), np.array([1])],
+                [np.array([1]), np.array([0])],
+                ["kl_divergence"],
+            )
+        self.assertAlmostEqual(result["kl_divergence"], self.expected)
+
+
+if __name__ == "__main__":
+    unittest.main()