title: Brief Report: Apparent Antiretroviral Overadherence by Pill Count is Associated With HIV Treatment Failure in Adolescents.
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.
authors.affiliation: Children's Hospital of Philadelphia, Philadelphia, PA, USA.|University of Pennsylvania Perelman School of Medicine, Masters of Public Health Program, Philadelphia, PA, USA.|University of Botswana, Gaborone, Botswana.
authors.forename: Harriet
authors.initials: H
authors.lastname: Okatch
authors.affiliation: Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Kaylin
authors.initials: K
authors.lastname: Beiter
authors.affiliation: Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Eby
authors.affiliation: Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Chapman
authors.affiliation: Botswana-Baylor Children's Clinical Centre of Excellence, Gaborone, Botswana.
authors.forename: Tafireyi
authors.initials: T
authors.lastname: Marukutira
authors.affiliation: Botswana-Baylor Children's Clinical Centre of Excellence, Gaborone, Botswana.
authors.forename: Ontibile
authors.initials: O
authors.lastname: Tshume
authors.affiliation: Botswana-Baylor Children's Clinical Centre of Excellence, Gaborone, Botswana.|Baylor College of Medicine, Department of Pediatrics, Section of Retrovirology, Houston, TX, USA.
authors.forename: Mogomotsi
authors.initials: M
authors.lastname: Matshaba
authors.affiliation: Botswana-Baylor Children's Clinical Centre of Excellence, Gaborone, Botswana.|Baylor College of Medicine, Department of Pediatrics, Section of Retrovirology, Houston, TX, USA.
authors.forename: Gabriel M
authors.initials: GM
authors.lastname: Anabwani
authors.affiliation: University of Pennsylvania Perelman School of Medicine, Departments of Medicine and Epidemiology, Philadelphia, PA, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Gross
authors.affiliation: Children's Hospital of Philadelphia, Philadelphia, PA, USA.|University of Pennsylvania Perelman School of Medicine, Departments of Pediatrics and Epidemiology, Philadelphia, PA, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Lowenthal
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D001902:Botswana; D004334:Drug Administration Schedule; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data*; D012646:Self Administration / Q000523:psychology / Q000706:statistics & numerical data*; D017211:Treatment Failure; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents