Terbinafine

[pozBear]

Hello!

I am now on my second month taking 250mg of daily terbinafine for my toenails because they got fungus. It's working very well and I feel nothing wrong. Labs also show nothing councerning liver and kidneys.

But cd4 has dropped sharply, from the previous 1000+ to 598... I have always been UD, take my meds with army discipline. Could this drop be due to the terbinafine?

My doctor says it's nothing to worry about because I am healthy and been keeping UD all along since 2013...

That's driving me worried anyways.

[leatherman]

while I know nothing about terbinafine, I do know some things about cd4 counts.

cd4s can change by 100 pts a day, so keep that in mind.

CD4s (and Viral loads) are not straight line functions (always going up or always going down). VL can be a very jumpy line when beginning treatment. CD4 can often be jumpy too.

and that's why you should never care about a single test. You should always view the trend - and that would be the trend of at least 3 tests preferably over several months or more.

I'm not going to do the math or graph out your numbers (try AidsMeds Graph Your Labs function for that); but take a look at the cd4s in your sig line.

484     343     270     320     412     589     1.100     598

ok I did some math. Leaving out the outlier of 1100, your average cd4 is a respectable 430. Leaving out the nearly doubled amount of 1100. your last 3 cd4s trend as 412, 589, 598. Remembering that the cd4s can change by nearly 100 pts in a single day, your trend is clearly holding nearly steady now just shy of 600.

Instead of worrying about a drop, you should probably just be ignoring that one weirdly out-of-place result and be happy for a very good immune system around 600 cd4s

also remember while cd4s are something measurable and science has shown that under 200 puts most everyone at risk for OIs, a "normal" count can be anyway from 400-1500. That's a huge range, and the larger number doesn't neccesarily mean that your immune system is that much better. some people are quite healthy at 400 and someone people have multiple health issues with >1000. It's not about how many tcells you have after you get about 200, it's about how well they work.    of course, how many is your "normal" count and how well they work is simple genetics. there's not much you can do about that but blame your parents and grandparents.  LOL

[pozBear]

Hello leatherman!

Your math is correct. I must really have a strong immune system, because I almost never get sick or feel bad. Terbinafine is helping me wonders with the toenails and I'd really like to finish off that treatment. Will continue keeping both eyes on the viral load and won't worry that much about the bouncing cd4's.

Thank you very much!