SUMMARY The titres of IgG antibody against "late antigens", "immediate early antigens", and "early antigens" induced by cytomegalovirus (CMV) and IgM antibody against "late antigens" induced by CMV were analysed in 67 geriatric subjects by immunocytochemical techniques. T1 titres obtained were compared with those ofan adult control population. Significantly increased titres of IgG antibody against induced antigens and a significant increase in CMV reactivated infections occurred in the elderly compared with control subjects.These findings indicate that the CMV and host balance in the elderly is disturbed, leading to activation of the CMV latent carrier state that follows primary CMV infection.Cytomegalovirus (CMV) is a member of the herpesviridae family. Although it can cause illnesses ranging from congenital malformations to serious complications in severely immunocompromised hosts, most infections occur asymptomatically, and by adulthood most people have serum antibodies to CMV, which are markers of prior infection. Like other herpes viruses CMV is able to remain latent in those infected with it until an appropriate stimulus or a lowering ofimmune barriers, or both, reactivates the virus.'Many studies on man and animals have shown that the efficiency of the immune system declines with age, and it has been suggested that in the elderly the responsiveness of the T cell mediated immune system, both in the effector and in the regulatory compartments, is impaired. 3 March 1988 and without evidence of malignant, haematological, endocrine, infectious or immunological disorders. As a control population, 67 sex-matched blood donors aged from 25 to 38 (mean age 33) were tested.The following determinations were made in each serum sample: (i) IgG against "immediate early antigen" (IEA) induced by CMV; IgG against "early antigen" (EA) induced by CMV; (iii) IgG against "late antigen" (LA) induced by CMV; and (iv) IgM against LA induced by CMV. A serological sign of active or recent infection was the concomitant presence of a titre of IgG anti-CMV induced LA of > 1/320, anti-EA of > 1/20, and anti-IEA of > 1/20; or the presence of IgM against CMV-induced LA of > 1/20.5To prepare IEA induced by CMV, human embryo fibroblasts infected with the Towne strain ofCMV and grown on coverslips were fixed in acetone one hour after infection. EA induced by CMV were prepared by fixing cells infected in the presence of 75 ,ug/ml of cytarabine, 72 hours after infection, to accumulate all EA synthesised before replication of viral DNA. LA induced by CMV were obtained by fixing infected cells 72 hours after infection.! Two reference sera were used to test antigen preparations: (BE 184, anti-LA titre 1/ 640, anti-EA titre 1/320, anti-IEA titre 1/160; CF 387, anti-LA titre 1/320, anti-EA and anti-IEA negative titres).An immunoalkaline phosphatase assay for the detection of IgG to LA induced by CMV, EA, and IEA was performed as previously described.8 Briefly, acetone fixed cells were treated with serial twofold dilutions of sera at 37'C fo...