Rhea J. LongleyMichael T. WhiteEizo TakashimaJessica BrewsterMasayuki MoritaMatthias HarbersThomas ObadiaLeanne J. RobinsonFumie MatsuuraZoe S.J. LiuConnie S.N. Li-Wai-SuenWai Hong ThamJulie HealerChristele HuonChetan E. ChitnisWang NguitragoolWuelton MonteiroCarla ProiettiDenise L. DoolanAndre M. SiqueiraXavier C. DingIveth J. GonzalezJames KazuraMarcus LacerdaJetsumon SattabongkotTakafumi TsuboiIvo MuellerFoundation for Innovative New Diagnostics, SwitzerlandWalter and Eliza Hall Institute of Medical ResearchUniversity of MelbourneQIMR Berghofer Medical Research InstituteJames Cook University, AustraliaRikenMahidol UniversityCNRS Centre National de la Recherche ScientifiqueCASE School of MedicineBurnet InstituteUniversidade do Estado do AmazonasEhime UniversityInstitut Pasteur, ParisLeônidas & Maria Deane Institute - Fiocruz AmazôniaFundação de Medicina Tropical Dr. Heitor Vieira DouradoInstituto Nacional de Infectologia Evandro ChagasCellFree Sciences Co., Ltd.2020-06-022020-06-022020-05-01Nature Medicine. Vol.26, No.5 (2020), 741-7491546170X107889562-s2.0-85084626398https://repository.li.mahidol.ac.th/handle/20.500.14594/56123© 2020, The Author(s), under exclusive licence to Springer Nature America, Inc. A major gap in the Plasmodium vivax elimination toolkit is the identification of individuals carrying clinically silent and undetectable liver-stage parasites, called hypnozoites. This study developed a panel of serological exposure markers capable of classifying individuals with recent P. vivax infections who have a high likelihood of harboring hypnozoites. We measured IgG antibody responses to 342 P. vivax proteins in longitudinal clinical cohorts conducted in Thailand and Brazil and identified candidate serological markers of exposure. Candidate markers were validated using samples from year-long observational cohorts conducted in Thailand, Brazil and the Solomon Islands and antibody responses to eight P. vivax proteins classified P. vivax infections in the previous 9 months with 80% sensitivity and specificity. Mathematical models demonstrate that a serological testing and treatment strategy could reduce P. vivax prevalence by 59–69%. These eight antibody responses can serve as a biomarker, identifying individuals who should be targeted with anti-hypnozoite therapy.Mahidol UniversityBiochemistry, Genetics and Molecular BiologyArticleSCOPUS10.1038/s41591-020-0841-4