Abstract
The Respiratory Syncytial Virus (RSV) is, globally, a prominent cause of acute lower respiratory tract infections (ALRTI) in both infants and the elderly. Recently, two vaccines and one monoclonal antibody (mAb) have been developed and approved for use in these populations. It is expected that the new mAb (Nirsevimab) will be widely administered to children under two years old in the upcoming RSV seasons. The extensive use of this prophylactic could induce unexpected changes in RSV infection and resistance mechanisms, as observed on a smaller scale worldwide with the use of the older and widely used mAb, palivizumab. Therefore, it is crucial to comprehend the evolution of RSV and predict potential mutations that may occur under the selective pressure exerted by these mAbs, posing a real threat to the efficacy of available preventive measures. Hence, the comprehensive approach presented in this project will enhance our understanding of how prophylactic measures may influence RSV evolution, providing valuable insights for public health strategies and preparedness against emerging RSV strains.
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