Hepatitis C on the rise in Tampere, Finland, linked to increased drug use

The occurrence of Hepatitis C is quickly escalating, correlating with an increase in drug use. This highly contagious liver infection is particularly spreading amongst intravenous drug users. The situation is especially dire in Tampere, Finland, where the disease has spread rapidly. Hepatitis C is a virus-induced liver inflammation that is predominantly transmitted through blood, such as shared drug injection equipment. The infected person often remains unaware of their condition, as the disease typically remains asymptomatic. Only one in four of those infected experience initial symptoms such as loss of appetite, fatigue, fever, joint and muscle pain, and yellowing of the skin and eyes. The majority of infected individuals become carriers of the virus, resulting in chronic infection. Chronic infection increases the risk of liver cirrhosis and liver cancer. There is currently no vaccine available against Hepatitis C. The infection is treated with orally administered and well-tolerated drugs.

According to a spring sewer water study by the Finnish Institute for Health and Welfare (THL), substantial spikes in urban drug use were also revealed. The situation is compounded by the fact that not all injecting drug users are tested. Ulriika Sundell, Medical Director of the A-Clinic, notes that many drug addicts are socially excluded, thus the services do not reach them. Consequently, only a portion of drug users have been successfully tested, indicating the actual disease situation may be even worse. In contrast, cities such as Helsinki have managed to control Hepatitis C more effectively than Tampere, primarily due to a seamless care path where both the city and external service providers have collaborated for years. Hepatitis C treatment and testing in Helsinki are strongly automated and integrated into other addiction treatment and care assessment.

In Tampere, however, the overall substance abuse services have been more unstructured than in the capital region for a long time. Sundell believes that for Hepatitis C to be controlled, testing should be as accessible as possible and the patient should receive medication quickly, without unnecessary bureaucracy. She also emphasizes that regional delegates can influence the values of drug treatment, and whether drug addiction is seen as a shared burden or an individual problem. If drug users are considered lost causes, Hepatitis C is merely one minor problem among others.

In Tampere, services for Hepatitis C treatment and testing are in many ways as well-structured as in the Helsinki region, according to Henri Sipilä, Service Manager of Mental Health and Substance Abuse Services in the Pirkanmaa region. However, he acknowledges that the situation regarding infections is better in the Helsinki area than in Tampere, and that there may be factors that need to be considered in the future when developing services. Sipilä adds that Hepatitis C treatment and testing are strongly included in the Pirkanmaa region’s current service agreements and production. These apply to every outpatient drug patient, both in purchased service production and in their own service production. Hepatitis C can also be treated at their own social and healthcare center.

In Pirkanmaa’s substance abuse work, the challenge is that there are many different services and paths for drug addicts to access within the wellness area. This may have made Hepatitis C treatment in Tampere less consistent and clear. However, testing and treatment for Hepatitis C are carried out very systematically. In principle, the services already exist, but the big challenge is how people find them.

According to THL, most Hepatitis C infections are detected in men aged 20-34. Most of those infected have used drugs by injection. A large proportion of intravenous users carry Hepatitis C. Eija Pitkänen, a physician working at the A-Clinic, is extremely concerned about both the increase in drug use and the number of infections. In the past five years, an average of 1,900 Hepatitis C carriers have been treated annually in Finland. The number of those needing drug treatment is estimated to be about 10,000-15,000. Many don’t see the need for treatment initially, as the disease doesn’t cause symptoms in the early stages. However, it is never too late, says Pitkänen. Finland aims to eliminate all Hepatitis C infections in the coming years. The goal is to treat all those infected, regardless of liver damage. If left untreated, the disease can lead to liver cirrhosis and liver cancer. Late-stage treatment of the disease is also very costly.