人类 T 细胞嗜淋巴细胞病毒 1 型 (HTLV-1) 传统上与成人 T 细胞白血病/淋巴瘤、HTLV-1 相关脊髓病和 HTLV-1 葡萄膜炎等严重疾病有关，可垂直传播，尤其是母婴传播彻底的母乳喂养被认为是主要途径。尽管日本努力通过产前筛查减少垂直传播，但水平传播仍导致大都市地区 HTLV-1 患病率上升。该病例报告了一名 18 岁女性因性接触水平传播而导致的最年轻的 HTLV-1 葡萄膜炎病例。患者右眼视力模糊，综合眼科检查发现玻璃体混浊和视网膜血管炎。血清学检测证实了 HTLV-1 感染，通过实时 PCR 测量，前病毒载量为每 100 个外周血单核细胞 2.66 个拷贝。鉴别诊断确诊为 HTLV-1 葡萄膜炎。进一步的家庭和伴侣调查证实了横向传播，最有可能通过性接触。经过 6 年的随访，患者多次复发 HTLV-1 葡萄膜炎，并出现 HTLV-1 相关角膜病。该病例突显了疾病在相对较低的原病毒载量和较短的潜伏期下快速进展的潜力，强调了针对性活跃的年轻人口更新公共卫生策略的必要性。© 2024 Wiley periodicals LLC。

Human T-cell Lymphotropic Virus Type 1 (HTLV-1) is traditionally linked to severe conditions such as adult T-cell leukemia/lymphoma, HTLV-1-associated myelopathy, and HTLV-1 uveitis, with vertical transmission, particularly mother to child thorough breastfeeding, considered the primary route. Despite efforts to reduce vertical transmission through antenatal screening in Japan, horizontal transmission has contributed to the rising prevalence of HTLV-1 in metropolitan areas. This case reports the youngest documented instance of HTLV-1 uveitis resulting from horizontal transmission through sexual contact in an 18-year-old woman. The patient presented with blurred vision in her right eye, and a comprehensive ophthalmologic examination identified vitreous opacity and retinal vasculitis. Serological tests confirmed HTLV-1 infection, with a proviral load of 2.66 copies per 100 peripheral blood mononuclear cells, measured by real-time PCR. A differential diagnosis confirmed HTLV-1 uveitis. Further family and partner investigations confirmed horizontal transmission, most likely through sexual contact. Over 6 years of follow-up, the patient experienced multiple recurrences of HTLV-1 uveitis and developed HTLV-1-associated keratopathy. This case highlights the potential for rapid disease progression with relatively low proviral loads and short latency, emphasizing the need for updated public health strategies for sexually active young populations.© 2024 Wiley Periodicals LLC.