# Primary HSV infection for first few days is associated with elevated level of immunoglobulin:
A. IgG
B. IgA
C. IgM
D. IgE
The correct answer is C. IgM.
Primary HSV infection is associated with elevated immunoglobulin (Ig)M titers that occur within days, followed several weeks later by permanent IgG titers (seroconversion) that indicate previous infection but confer no protection against reactivation. Recurrent infection is associated with a rise in IgG antibody titer in acute and convalescent sera, but a fourfold rise (a criterion that indicates active infection) is seen in only 5% of patients. The assay for HSV IgM is not particularly reliable for diagnostic purposes and overall, the use of serology to diagnose recurrent infection is not advised.
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