Objective  To investigate the effects of C-reactive protein (CRP) levels and JAK2 rs10119004 gene polymorphisms on voriconazole serum trough concentration (VCZ-C_min) in patients with invasive fungal disease.

Methods  Patients with invasive pulmonary fungal infections who received oral and intravenous VCZ treatment at Changsha Central Hospital from January 2021 to January 2023 were included. The JAK2 rs1011904 gene polymorphism was performed using Sanger sequencing and VCZ-C_min was determined by HPLC. Through statistical analysis, the difference was compared in VCZ- C_min between patients with different JAK2 rs10119004 genotypes, the correlation between CRP levels and VCZ-C_min was explored, and the effect of CRP levels on VCZ-C_min under different genotypes was investigated.

Results  A total of 121 patients were collected. The VCZ-C_min of JAK2 rs10119004 GG genotype patients was higher than that of AG and AA genotype patients, and the difference in VCZ-C_min between different genotypes in the oral administration group was more significant than that in the intravenous injection group. Pearson correlation analysis showed a positive correlation between CRP levels and VCZ-C_min. Stratified analysis further indicated that the JAK2 rs10119004 genotype had a regulatory effect on this correlation, especially in AG genotype patients, where VCZ-C_min was significantly higher in patients with high CRP levels than in those with low CRP levels.

Conclusion  When using VCZ in clinical practice, attention should be paid to the impact of JAK2 rs10119004 gene polymorphism and inflammatory status on VCZ-C_min, especially for patients carrying JAK2 rs10119004 GG or AG genotypes with high CRP levels, monitoring of VCZ-C_min should be strengthened..

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