Missed and Delayed Diagnoses of Acute Human Immunodeficiency Virus (HIV) Infection in a Southern Opt-Out HIV Testing Environment Without Reflex HIV RNA Testing.

Prompt confirmation of human immunodeficiency virus (HIV) is critical. We examined 10 years of discordant results without reflex HIV RNA. Of patients with acute HIV infection, 43.9% (95% confidence interval, 36.2%-52.0%) had confirmation delays >30 days or were never confirmed, indicating a need for reflex RNA to facilitate diagnosis.