We used heteroduplex mobility assay (HMA) to determine the genetic variability of 118 respiratory syncytial virus (RSV) field isolates from 19 epidemics occurring in a Japanese urban area between 1980 and 2000. Nucleotides 1 to 584 of the attachment G glycoprotein gene were amplified by reverse transcription-PCR, and the PCR amplicons were analyzed by HMA by using the earliest isolate from 1980 as the reference throughout. We also performed PCR-restriction fragment length polymorphism (RFLP) analysis and phylogenetic analysis on the same nucleotide sequence. PCR-RFLP revealed 9 patterns, whereas HMA produced 31 distinct patterns. The RFLP patterns were divided into two to seven distinct HMA genotypes. Field strains with similar degrees of G gene nucleotide differences from the reference strain often showed distinct HMA types. The RSV genetic heterogeneity detected by direct sequencing of the PCR amplicon was usually identical to HMA analysis. Analysis of the molecular epidemiology of RSV subgroup A isolates obtained by HMA showed that new RSV variants emerged with each epidemic and that previously dominant variants seldom recurred in subsequent epidemics. HMA is useful in detecting genetic variants of RSV subgroup A and has some advantages over other conventional methods.Human respiratory syncytial virus (RSV) is the most important viral pathogen causing lower respiratory tract infections in infants, immunocompromised hosts, and the elderly (15,16,27). Epidemics of RSV occur every winter in temperate climates, during rainy seasons, or year round in tropical regions (28). RSV can infect the same individual repeatedly and infants under 6 months of age who still possess maternal antibodies against the virus (21). These findings prompted one hypothesis that RSV infection may not produce a sufficient immune response against different strains of the virus because of the extensive genetic variability of the strains circulating in a community and worldwide.RSV was initially found to have two distinct antigenic groups, designated A and B, by their different reactivity with monoclonal antibodies against the viral antigens (1, 20). Epidemiology studies of RSV demonstrated that both antigenic groups circulate concurrently or alternately in a community during epidemics (18,32). Among viral surface antigens, the attachment G glycoprotein (G protein) has the greatest antigenic diversity between these two groups and among strains within each group. The G-protein variability is concentrated in its ectodomain, which contains two hypervariable regions separated by a conserved 11-amino-acid motif (4,7,19,29). Recent molecular epidemiological studies suggest that many distinct RSV genotypes circulate worldwide and that similar genetic variants are clustered by time rather than by geographic location (6,8,17,26).Genetic variability of RSV has most often been studied by using restriction fragment length polymorphism (RFLP) analysis and DNA sequencing (4, 30). RFLP analysis is relatively easy to perform, although genotypes obtained by ...