Are up to 80% or more of detectable Plasmodium vivax malarial recurrences relapses (a relapse being a hypnozoite-mediated recurrence)? This is a topical matter and a very interesting question.
The answer is that it is indeed a distinct possibility. The prevailing idea that recurrent bouts of P. vivax malaria are predominantly relapses is an assumption which is extremely tempting to make. It is based primarily on compelling data involving drug treatment with primaquine. Nevertheless, the assumption is not necessarily correct. Reasons why conceivably not are provided here (click on link):
The bottom line is that there is not yet any definitive proof, one way or the other, as to whether non-reinfection P. vivax malarial recurrences are mostly relapses (as opposed to recrudescences). The jury is still out on this.