Molecular epidemiology and phylogenetic analysis of human respiratory syncytial virus type B in Riyadh, Saudi Arabia.

The human respiratory syncytial virus (HRSV), recently known as the human orthopneumovirus (HOPV), continues to generate new variants with the ability to cause recurrent infections. Data regarding HRSV-B evolution and genetic diversity in Riyadh, Saudi Arabia, are very limited. Therefore, the current study was designed to investigate the prevalence, genetic diversity, and evolution of HRSV-B. A total of 200 nasopharyngeal aspirate (NPA) samples from hospitalized children at King Khaled University Hospital were screened for the presence of HRSV-B. The second hypervariable region (2nd HVR) of the G gene from all 37 HRSV-B genotypes was used to study sequences and family trees. Of the 200 screened nasopharyngeal samples (NPAs), 16 (8%) were positive for HRSV-B, with a high incidence rate in the age group of 2 to 5 months. The analysis of the 2nd HVR region's sequence showed several differences, such as point mutations, different protein lengths, sequence gaps, duplication regions, and glycosylation sites. A total of 46-point mutations were reported, of which 29 changed their corresponding amino acid residues. N-linked glycosylation sites in Riyadh strains were 3, whereas O-linked glycosylation sites ranged from 22 to 32. Phylogenetic analysis revealed that Riyadh strains from the seasons 2019/20 and 2022/23 are grouped into the subclade BA-11. Other Riyadh strains from different previous seasons were clustered into different sub-genotypes (BA-9, -10, and -12). Seasonal surveillance and molecular evolution tracking of HRSV-B is essential for the early detection of viral genotypes that might cause severe illness consequences and widespread transmission.