Delineating RSV-A and RSV-B: Epidemiological Patterns, Diagnostics, Clinical Severity, and Preventive Approaches

Area of Science:

• Virology
• Epidemiology
• Immunology

Background:

• Respiratory syncytial virus (RSV) is a major global cause of acute respiratory infections.
• Infants, older adults, and immunocompromised individuals are at highest risk for severe RSV disease.
• RSV has two main antigenic subgroups: RSV-A and RSV-B, with RSV-A often considered more dominant.

Purpose of the Study:

• To review and synthesize evidence on the global epidemiology, clinical impact, and virology of RSV-A and RSV-B.
• To assess the shifting patterns of dominance and disease severity between RSV subgroups.
• To highlight the need for comprehensive prevention strategies against both RSV subgroups.

Main Methods:

• Comprehensive literature review of epidemiological, clinical, virological, and immunological data.
• Analysis of molecular surveillance data to track genotype evolution.
• Synthesis of evidence regarding disease burden and immune responses.

Main Results:

• Both RSV-A and RSV-B co-circulate globally with dynamic patterns of dominance.
• Both subgroups demonstrate a comparable capacity to cause severe respiratory illness.
• Molecular surveillance reveals ongoing genotype evolution in both RSV groups, impacting epidemics and immune evasion.

Conclusions:

• RSV-A is not consistently more virulent or transmissible than RSV-B.
• Continuous genomic monitoring of RSV is crucial for understanding evolving epidemic patterns.
• Broadly protective vaccines and monoclonal antibodies targeting both RSV-A and RSV-B are essential for reducing RSV morbidity and mortality.