Abstract
Human respiratory syncytial virus (RSV) is a pathogen that causes severe respiratory illness in humans, primarily infecting infants, young children, the elderly, and adults with chronic health conditions. Each year, approximately 3.6 million children under the age of 5 are hospitalized worldwide, with over 100 000 fatalities reported. Currently, available RSV vaccines and antiviral drugs have several limitations, including inadequate immune persistence, limited applicability to specific populations, strict timing of treatment, and the risk of adverse reactions. RSV spreads through three main infection modes: syncytia formation, receptor-dependent infection of free viral particles, and transmission via actin filaments. These modes of transmission are key pathways that contribute to viral spread and pathogenicity while exposing potential targets for prevention and treatment. This is a complex process involving multiple aspects that remain not fully understood. Here, we review the mechanisms by which RSV infects and spreads within the host and explore the role of host factors in these processes, aiming to provide a theoretical and practical basis for identifying potential antiviral targets.