Respiratory syncytial virus prevention in immunocompromised hosts: gaps and opportunities.

Abstract

Purpose of review: Respiratory syncytial virus (RSV) poses a significant threat to immunocompromised individuals, yet preventive strategies and treatments remain largely unstudied in this population. New vaccines, mAbs, and antiviral agents are becoming available, with implications for high-risk patients.

Recent findings: RSV in immunocompromised individuals often leads to severe disease, prolonged illness, and treatment delays. Diagnostic challenges and the heterogeneity of immunosuppression complicate management. Recent advances include preF-based vaccines and monoclonal antibodies, though current recommendations exclude many immunocompromised patients. Early vaccine trials showed mixed immunogenicity results in this group and real-world effectiveness remains unclear. Antiviral agents are also under investigation, though efficacy data in immunocompromised hosts are limited. Infection prevention strategies remain critical in this high-risk group.

Summary: Despite promising advances in RSV prevention and treatment, immunocompromised patients remain underrepresented in clinical research. Targeted studies are urgently needed to determine optimal strategies for this vulnerable group. Until then, clinicians must rely on limited evidence and institutional protocols to guide care.