OBJECTIVE: To investigate the distribution characteristics of voriconazole plasma trough concentration in patients with acquired immunodeficiency syndrome（AIDS） complicated with fungal infection

analyze the influencing factors of voriconazole trough concentration

and evaluate the medication safety. METHODS: General data

biochemical indicators

renal function

drug combination and adverse events of patients with AIDS complicated with fungal infection treated with voriconazole in this hospital from Jul. 2019 to Apr. 2021 were retrospectively collected. Ultra-high performance liquid chromatography tandem mass spectrometry was used to detect the steady-state trough concentration during drug administration

and statistical analysis was performed by using SPSS 25.0 software. RESULTS: A total of 112 patients with AIDS complicated with fungal infection were included in this study. The initial median voriconazole trough concentration was 3.4 μg/mL（from 1.8 μg/mL to 5.8 μg/mL）

and 43 patients were not within the treatment window（from 0.5 μg/mL to 5.0 μg/mL）. After adjusting the dose for 40 patients whose trough concentration was not within the treatment window（the remaining 3 patients were discontinued）

the number of patients with appropriate concentration increased from 61.6%（69/112） to 87.5%（35/40）. Analysis of influencing factors showed that aspartate aminotransferase（AST）

aspartate aminotransferase/alanine aminotransferase（AST/ALT）

albumin levels and drug combination of proton pump inhibitors had significant effects on voriconazole trough concentration（P<0.05）

in which AST/ALT and albumin levels were independent risk factors affecting voriconazole trough concentration. Meanwhile

the steady-state trough concentration of voriconazole showed significant correlation with adverse events（P<0.05）. CONCLUSIONS: During the use of voriconazole in patients with AIDS complicated with fungal infection

attention should be paid to the influence of liver function（AST

AST/ALT）

albumin levels and drug combination of proton pump inhibitors on trough concentration. Along with therapeutic drug monitoring of voriconazole

other voriconazole-related visual and psychiatric abnormalities and other adverse events should be adequately monitored to ensure medication safety.