During his medical training, Dr Wayne Bai was asked to review a Chinese man in his late 30s who’d just been diagnosed with advanced hepatocellular carcinoma. The man’s condition was due to untreated chronic hepatitis B (CHB), and Wayne says it was a devastating situation for him and his family with a newborn. It was also avoidable.
“Liver cancer is a preventable disease thanks to hepatitis B (HBV) immunoglobulin at birth, HBV vaccination and direct-acting antivirals,” Wayne says. “Unfortunately, situations like this are not uncommon, as hepatitis B-related HCC can develop before the liver becomes cirrhotic and is generally more aggressive.”
The man’s case prompted Wayne’s decision to support more hepatitis B patients with early intervention, to help lessen their health burden. He is now a gastroenterologist at Waikato Hospital and is particularly interested in portal hypertension and fatty liver disease. Originally from Hong Kong, Wayne came to New Zealand in 1993. He's fluent in Cantonese and Mandarin and belongs to the NZ Society of Gastroenterology, American Association for the Study of Liver Diseases and the European Association for the Study of the Liver. He works closely with Chinese and other patients and says regular testing for at-risk people enables early diagnosis – and treatment – of hepatitis B. People at risk of contracting HBV are those from a Maori, Pacific or Asian ethnicity, unless they have been fully vaccinated as an infant. People born in an area of high hepatitis B endemicity, including Asia, are also at risk. The virus is particularly common in people with a family history of HBV transmitted vertically.
“I’ve seen the heavy burden of liver disease throughout my medical training,” Wayne says. “The common causes of liver disease are hepatitis B (HBV), hepatitis C (HCV), alcohol and non-alcoholic steatohepatitis (NASH). As the liver becomes progressively damaged, it develops cirrhosis and serious complications such as liver cancer leading to death.
As HBV progresses, regardless of the aetiology, symptoms such as jaundice, general lethargy, mental confusion, fluid accumulation in the legs and abdomen and unintentional weight loss can emerge. Chronic hepatitis B is often a lifelong condition, but the decision to treat people with it depends on several factors including age, serial ALT and HBV DNA levels and degree of fibrosis.
Wayne says there is also an increasing incidence of NASH-related liver disease/cirrhosis, due to the epidemic of obesity and diabetes. Common characteristics of NASH include patients with metabolic risk factors such as type two diabetes, obesity, hypertension, and hyperlipidemia.
“Liver disease is expected to be the third highest cause of cancer-related mortality around the world by 2030. These are highly preventable outcomes if the disease was addressed early, and this is what interested me in helping people with hepatitis B and other liver conditions.”
Wayne is a member of the New Zealand Society of Gastroenterology, American Association for the Study of Liver Diseases (AASLD) and the European Association for the Study of the Liver (EASL).
For advice or support from Wayne or another member of our clinical team please contact us.