{"doi":"10.1111/bjh.20258","title":"The Duffy antigen: A narrative review of testing, epidemiology, neutrophil counts and clinical consequences","abstract":"<jats:title>Summary</jats:title><jats:p>The null variant of the Duffy antigen is a non‐pathological mutation that is partially protective against <jats:italic>Plasmodium vivax</jats:italic> and results in a lower absolute neutrophil count (ANC) in peripheral blood without increasing the risk of infection. Healthcare practices, clinical trials eligibility and medication dosing are often influenced by the definition of neutropenia. In many regions, however, neutropenia has been defined by the ANC distribution of Duffy‐positive individuals, which may be unsuitable for decision‐making in Duffy null individuals. This review describes the association between Duffy status, <jats:italic>Plasmodium vivax</jats:italic> exposure, racial or ethnic groupings and ANC. We outline biological and iatrogenic associations between Duffy antigen status and health outcomes and recommend changes to healthcare practices required to ensure equity for Duffy null individuals.</jats:p>","journal":"British Journal of Haematology","year":2025,"id":599627,"datarank":0.20794415416798362,"base_score":1.3862943611198906,"endowment":1.3862943611198906,"self_citation_contribution":0.20794415416798362,"citation_network_contribution":0.0,"self_endowment_contribution":0.20794415416798362,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":88148,"name":"Jennifer Jones","orcid":"0000-0001-6936-6092","position":1,"is_corresponding":false},{"id":672209,"name":"Andrew Hantel","orcid":"0000-0001-9612-3643","position":2,"is_corresponding":false},{"id":536312,"name":"Lauren E. Merz","orcid":"0000-0002-6618-803X","position":3,"is_corresponding":false},{"id":1536786,"name":"Stephen P. Hibbs","orcid":"0000-0002-3663-2742","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"The Duffy antigen: A narrative review of testing, epidemiology, neutrophil counts and clinical consequences","abstract":"<jats:title>Summary</jats:title><jats:p>The null variant of the Duffy antigen is a non‐pathological mutation that is partially protective against <jats:italic>Plasmodium vivax</jats:italic> and results in a lower absolute neutrophil count (ANC) in peripheral blood without increasing the risk of infection. Healthcare practices, clinical trials eligibility and medication dosing are often influenced by the definition of neutropenia. In many regions, however, neutropenia has been defined by the ANC distribution of Duffy‐positive individuals, which may be unsuitable for decision‐making in Duffy null individuals. This review describes the association between Duffy status, <jats:italic>Plasmodium vivax</jats:italic> exposure, racial or ethnic groupings and ANC. We outline biological and iatrogenic associations between Duffy antigen status and health outcomes and recommend changes to healthcare practices required to ensure equity for Duffy null individuals.</jats:p>","is_dataset_classified":null,"base_score":1.0986122886681096,"endowment":1.0986122886681096,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"40685916","pmcid":null,"openalex_id":"https://openalex.org/W4412512392","authors":[],"funders":[{"funder_name":"Wellcome Trust","grant_id":"223500/Z/21/Z","title":null}],"total_grants":1,"fwci":1.0528,"citation_percentile":0.7319933,"influential_citations":0,"citation_trend":[{"year":2025,"count":1},{"year":2026,"count":1}],"oa_status":"closed","license":"http://onlinelibrary.wiley.com/termsAndConditions#vor","oa_locations":[{"url":"https://onlinelibrary.wiley.com/doi/pdf/10.1111/bjh.20258","host_type":"publisher"},{"url":"https://doi.org/10.1111/bjh.20258","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/40685916","host_type":"repository"}],"fields_of_study":["Blood groups and transfusion","Blood disorders and treatments","Complement system in diseases"],"mesh_terms":["Duffy Blood-Group System","Humans","Leukocyte Count","Neutropenia","Neutrophils","Plasmodium vivax","Receptors, Cell Surface","Malaria, Vivax"],"keywords":["Immunology","Epidemiology","Antigen","Narrative","Medicine","Narrative review","Intensive care medicine","Internal medicine","Blood groups","Neutropenia","Red Cell Antigens","Clinical Haematology","General Haematology","Chronic Neutropenia"],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-07-29T10:53:41.105145Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}