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

Respiratory syncytial virus (RSV) is a leading cause of acute respiratory infections globally, particularly affecting infants, older adults, and individuals with chronic conditions. RSV comprises two major antigenic subgroups, RSV-A and RSV-B, with RSV-A traditionally viewed as the dominant, more transmissible, and virulent strain. In this comprehensive review, we synthesize epidemiological, clinical, virological, and immunological evidence to demonstrate that both subgroups co-circulate worldwide with shifting patterns of dominance and a comparable capacity to cause severe disease. Molecular surveillance shows dynamic genotype evolution in both groups, influencing epidemic patterns and immune recognition. These findings underscore the need for continuous genomic monitoring and the widespread use of broadly protective preventive measures, including vaccines and monoclonal antibodies, that target both RSV-A and RSV-B to effectively reduce RSV-associated morbidity and mortality.