Detection of herpes simplex and varicella-zoster virus from skin lesions: comparison of RT-PCR and isothermal amplification for rapid identification

We compared 2 molecular tests for detection of herpes simplex viruses 1 and 2 (HSV-1, HSV-2) and varicella-zoster virus (VZV): real-time polymerase chain reaction (RT-PCR) (Argene, BioMerieux, France) performed on an LC480 platform (Roche Applied Science, Mannheim, Germany) and isothermal amplification using a Solana HSV1 + 2/VZV assay (Quidel Corporation Worldwide Headquarters, San Diego, CA) with helicase-dependent amplification performed by a Solana® instrument. With both methods, HSV-1 was detected in 68/291 (23.4%), HSV-2 in 23/291 (7.9%), and VZV in 48/291 (16.5%) skin lesions. Both methods agreed completely only in detection of HSV-2 (kappa = 1). Concordance between Solana HSV1 + 2/VZV and RT-PCR was 98.3% (kappa = 0.95) for HSV-1 and 99.3% (kappa = 0.98) for VZV. Rapid detection of HSV-1, HSV-2, and VZV using the Solana platform is a useful method for routine diagnostics and for urgent swab samples requiring a short turnaround time.