Brief Report: Apparent Antiretroviral Overadherence by Pill Count is Associated With HIV Treatment Failure in Adolescents

J Acquir Immune Defic Syndr. 2016 Aug 15;72(5):542-545. doi: 10.1097/QAI.0000000000000994.

Abstract

Pill counts with calculated adherence percentages are used in many settings to monitor adherence, but can be undermined by patients discarding pills to hide nonadherence. Pill counts suggesting that >100% of prescribed doses were taken can signal "pill dumping." We defined "overadherence" among a cohort of 300 HIV-infected adolescents as having greater than one-third of pill counts with >100% adherence during a year of follow-up. Apparent overadherence was more common in those with virologic failure than in those with suppressed viral loads (33% vs 13%, χ(2) P = 0.001). Pill count adherence repeatedly >100% may identify HIV-infected adolescents at increased risk of treatment failure.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adolescent Behavior* / psychology
  • Anti-HIV Agents / administration & dosage*
  • Botswana
  • Drug Administration Schedule
  • Follow-Up Studies
  • HIV Infections / drug therapy*
  • HIV Infections / psychology
  • Humans
  • Patient Compliance / psychology
  • Patient Compliance / statistics & numerical data*
  • Self Administration / psychology
  • Self Administration / statistics & numerical data*
  • Treatment Failure
  • Viral Load

Substances

  • Anti-HIV Agents