Virus herpes simple


La infección por el virus herpes es una de las más frecuentes en nuestro medio. Según una nota descriptiva emitida por la OMS en 2017, un 67% de la población mundial menor de 50 años vive con infección por VHS-1 o 2 ¿Conocías este dato? A continuación te contamos más.
¿Qué es el virus herpes?
La familia de los virus herpes es muy numerosa, pero en el post de hoy hablaremos del virus herpes simple (VHS) . Este virus tiene dos cepas o variantes: el VHS-1 y el VHS-2. El VHS-1 se transmite por contacto boca-boca, mientras que el VHS-2 se transmite por contacto sexual.
Estos virus, tras infectar por primera veza una persona, se quedan latentes en las células del huésped, pudiendo “despertar” ocasionalmente y provocar nuevos episodios. Son, por ello, infecciones “de por vida”.
¿Qué me produce el virus herpes simple?

  1. El VHS-1 es muy contagioso y se entra en contacto con él durante la infancia. Sin embargo, la mayoría de las personas infectadas por VHS-1 son asintomáticas y desconocen que lo están. La lesión por excelencia del VHS-1 es el herpes labial, que provoca la aparición de vesículas o úlceras en labios o alrededor de la boca (que coloquialmente llamamos calenturas). Tras la primera infección, las calenturas pueden reaparecer periódicamente. En ocasiones, el VHS-1 puede producir síntomas también a nivel genital.
  2. El VHS-2 se transmite exclusivamente por contacto sexual. Los síntomas producidos son muy similares a los del VHS-1, aunque ahora se concentrarán en la región genital o anal. Además, pueden acompañarse de fiebre, dolores en la región y aparición de ganglios. El VHS-2 produce una clínica más grave y molesta que el VSH-1 y tiende a reaparecer con más frecuencia.

¿Qué hará el médico en la consulta?
Cuando acuda a su médico y le explique los síntomas que tiene, se le preguntará si es la primera ocasión que ha tenido estas lesiones, o las ha sufrido ya previamente. Además, en función de la localización de las lesiones, puede preguntarle por posibles contactos sexuales de riesgo o prácticas de sexo oral, ya que tiene relevancia para establecer el diagnóstico. A continuación, procederá a examinar con más detenimiento las lesiones.
El diagnóstico es fundamentalmente clínico, con la observación de las lesiones, aunque en situaciones que puedan plantear duda, es posible pedir unos análisis para distinguir este virus.
¿Qué tratamiento hay para estos casos?
Existen fármacos antivíricos comunes para ambos virus, que han demostrado eficacia para reducir la intensidad de los síntomas y su frecuencia, pero actualmente no existen tratamientos para curar la infección, sólo para aliviar los síntomas.
¿Qué tratamientos pueden aliviar las molestias?
Al tratarse de una infección vírica el principal tratamiento es síntomatico. Si existen molestias generalizadas podemos utilizar analgésicos habituales como paracetamol e ibuprofeno.
Ante las lesiones locales a nivel oral, son muy útiles las instilaciones con alcohol varias veces al día para secar las heridas. En las lesiones a nivel genital el médico puede pautar preparados farmacéuticos (borato sódico o el sulfato de zinc) para realizar fomentos en la zona que permitan el secado.
¿Se puede prevenir el contagio?
El contagio del VHS se produce a través de contacto con las úlceras o saliva de la persona contagiada, especialmente cuando la persona infectada tiene síntomas de infección activa. En estas situaciones se debe evitar el contacto bucal con otras personas, así como el contacto buco-genital para evitar el contagio. El uso adecuado de preservativos contribuye a reducir el riesgo de infección.


Álvaro García García . Marta González Gago.
Alumnos de 6º . Facultad de Medicina. Valladolid.

Yolanda Granja Garrán.
Médico de familia. Centro de salud Plaza del Ejercito. Valladolid Oeste.

 
 
REFERENCIAS:

  1. Martín Zurro A, Cano Pérez JF, Gené Badia J. Capítulo 48: Infecciones de transmisión sexual e infección por el virus de la inmunodeficiencia humana. En: Compendio de atención primaria: conceptos, organización y práctica clínica en Medicina de Familia. 7a Edición. Barcelona: Elsevier; 2016. p. 534-48.
  2. Herpes Simplex: Background, Microbiology, Pathophysiology. 1 de marzo de 2018 [citado 31 de marzo de 2018]; Disponible en: https://emedicine.medscape.com/article/218580-overview
  3. OMS | Virus del herpes simple [Internet]. WHO. [citado 31 de marzo de 2018]. Disponible en: http://www.who.int/mediacentre/factsheets/fs400/es/

 
Revisado: abril 2018

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