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RSV comprises two major antigenic subgroups, RSV\u2010A and RSV\u2010B, with RSV\u2010A 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\u2010circulate 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. 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