Advances in Detection Methods for Human Respiratory Syncytial Virus Neutralizing Antibodies

Human respiratory syncytial virus (HRSV) is a major cause of severe lower respiratory tract infections in infants, young children, and older adults worldwide. With the approval of nirsevimab and HRSV vaccines, accurate measurement of neutralizing antibody levels has become essential for vaccine evaluation, immunization strategy design, and seroepidemiology. The plaque reduction neutralization test (PRNT) remains the gold standard, but it is slow, low-throughput, and requires high biosafety. In recent years, newer methods including focus reduction neutralization testing (FRNT), pseudovirus neutralization testing (PNT), and fluorescent/luminescent reporter virus systems (RVSs) have improved speed and throughput while maintaining high specificity. This review summarizes the principles, performance, applications, and standardization challenges of these assays, offering methodological guidance for HRSV research and prevention in China.