Erythrocyte invasion by Plasmodium vivax is completely dependent on binding to the Duffy blood group antigen by the parasite Duffy binding protein (DBP). The receptor-binding domain of this protein lies within a cysteine-rich region referred to as region II (DBPII).To examine whether antibody responses to DBP correlate with age-acquired immunity to P. vivax, antibodies to recombinant DBP (rDBP) were measured in 551 individuals residing in a village endemic for P. vivax in Papua New Guinea, and linear epitopes mapped in the critical binding region of DBPII. Antibody levels to rDBP II increased with age. Four dominant linear epitopes were identified, and the number of linear epitopes recognized by semiimmune individuals increased with age, suggesting greater recognition with repeated infection. Some individuals had antibodies to rDBP II but not to the linear epitopes, indicating the presence of conformational epitopes. This occurred in younger individuals or subjects acutely infected for the first time with P. vivax, indicating that repeated infection is required for recognition of linear epitopes. All four dominant B-cell epitopes contained polymorphic residues, three of which showed variant-specific serologic responses in over 10% of subjects examined. In conclusion, these results demonstrate age-dependent and variant-specific antibody responses to DBPII and implicate this molecule in partial acquired immunity to P. vivax in populations in endemic areas.Plasmodium vivax malaria is widely distributed throughout the world and accounts for over half of all malaria infections outside of Africa and about 10% of malaria infections in Africa (15). The intraerythrocytic stage of the parasite in humans requires specific receptor-ligand interactions for successful invasion of its host (6). P. vivax invasion of erythrocytes is absolutely dependent on binding to the Duffy blood group. As a result, Duffy-negative individuals are completely resistant to P. vivax malaria (19). One member of a large family of erythrocyte binding proteins, referred to as the Duffy binding protein (DBP), mediates binding to the Duffy blood group or Duffy receptor for chemokines (DARC), since this Duffy blood group antigen has been identified to be a chemokine receptor (14). The critical binding motif of P. vivax DBP lies within a cysteine-rich domain referred to as region II between amino acids (aa) 291 and 460 (21). Region II of DBP (DBPII) may be a critical target for host protective immunity, based on several observations. First, certain regions of DBPII are highly polymorphic (24, 25) and appear to be maintained by immune selection (11). Second, antibodies to DBPII from populations in areas endemic for P. vivax inhibit binding of COS-7 cells that express DBPII ligand on their surface to DARC-positive erythrocytes (16, 23). Third, antibodies raised to region II of the Plasmodium knowlesi ␣ protein, a molecule that is 70% homologous to P. vivax DBP and also mediates DARC-dependent infection of human erythrocytes, can inhibit P. knowlesi invasio...