TY - JOUR AU - Ngowi, Kennedy Michael AU - Masika, Lydia AU - Lyamuya, Furaha AU - Muro, Eva AU - Mmbaga, Blandina T. AU - Sprangers, Mirjam A. G. AU - Nieuwkerk, Pythia T. AU - Aarnoutse, Rob E. AU - Reiss, Peter AU - Sumari-de Boer, I. Marion PY - 2020 DA - 2020/09/10 TI - Returning of antiretroviral medication dispensed over a period of 8 months suggests non-adherence despite full adherence according to real time medication monitoring JO - AIDS Research and Therapy SP - 57 VL - 17 IS - 1 AB - Real-time medication monitoring (RTMM) may potentially enhance adherence to antiretroviral treatment (ART). We describe a participant in an ongoing trial who, shortly after completing trial participation, died of cryptococcal meningitis despite high levels of adherence according to self-report, pill-counts and RTMM (> 99%). However, she evidenced consistently high HIV viral load throughout the 48-week study follow-up. Subsequently, her relatives unsolicitedly returned eight months’ dispensed ART medication that she was supposed to have taken. This brief report illustrates the challenges of adherence measurements including RTMM, and reinforces the need to combine adherence assessments with viral load monitoring in HIV care. SN - 1742-6405 UR - https://doi.org/10.1186/s12981-020-00313-z DO - 10.1186/s12981-020-00313-z ID - Ngowi2020 ER -