Going for three: what is the role for triplex testing for HSV-1, HSV-2, and VZV?

November 4, 2025
Clinical Microbiology
David R Peaper
Pathogen:Herpes simplex virus-1, Herpes simplex virus-2, Varicella zoster virus
Infection Type:Mucocutaneous infection
Pathogen Type:Virus

Summary

Herpes simplex virus-1 (HSV-1), HSV-2, and varicella zoster virus (VZV) are common causes of mucocutaneous lesions, with diagnostic methods shifting towards nucleic acid amplification tests (NAATs). This article discusses the utility of triplex testing for these viruses, which can improve diagnostic efficiency. While traditional methods like culture and direct fluorescent antibody testing were once standard, NAATs offer enhanced sensitivity and specificity. The case highlights the importance of considering co-infections or differentiating between these closely related viral presentations, particularly when symptoms are atypical or severe. Triplex testing can guide appropriate antiviral therapy and infection control measures.

Key note: Triplex testing for HSV-1, HSV-2, and VZV offers a comprehensive and efficient diagnostic approach for mucocutaneous lesions, aiding in precise diagnosis and management.

DOI: 10.1128/asmcr.00152-25