Clevudine has been approved for the treatment of
chronic hepatitis B (CHB) in South Korea. However, its long-term
antiviral effect and safety awaits more study. The aim of this study was to evaluate
antiviral efficacy, predictors of virologic response, and development of
myopathy after
clevudine therapy for CHB. The study included 102
nucleoside naïve CHB patients who had received
clevudine for more than 6 months with good compliance. The median duration of
clevudine treatment was 53 weeks (range, 25-90 weeks). A retrospective analysis of data retrieved from medical records was performed. The cumulative rate of virologic response [hepatitis B virus (HBV)
DNA level <2000 copies/mL] at 48 weeks of
clevudine therapy was 81%, and cumulative rate of
clevudine resistance was 11% at 60 weeks of treatment. Independent predictors of virologic response to
clevudine therapy were
hepatitis B e antigen (
HBeAg) negativity and rapid decrease of viral load during the early phase of treatment. The
clevudine-related
myopathy developed in 3.9% of patients, and was reversible after discontinuation of
clevudine.
Clevudine showed a potent
antiviral response, and its effect was higher in
HBeAg-negative patients, with rapid viral load reduction after
therapy. However, long-term
therapy for more than 1 year resulted in the development of considerable resistance and
myopathy. Therefore, we should consider alternative
antiviral agents if
clevudine resistance or
clevudine-induced
myopathy is developed in patients on
clevudine for the treatment of CHB.