Abstract: Objective The aim of this study was to investigate the efficacy and safety of sofosbuvir (SOF) and velpatasvir (VEL) plus or not plus ribavirin in the treatment of patients with chronic hepatitis C-related compensated liver cirrhosis (CHC-CLC) and decompensated liver cirrhosis (CHC-DLC). Methods 36 patients with CHC-CLC and 27 patients with CHC-DLC were enrolled in this study between March 2020 and March 2022, and all patients received SOF and VEL and the patients with CHC-DLC were added with ribavirin for 12 weeks. The patients were followed-up for 48 weeks. The early virological response rate (EVR), the end of treatment response (EOT), the sustained virological response at 24 weeks (SVR24) and the SVR at 48 weeks (SVR48) after the discontinuation of the regimen were recorded. Results The incidences of esophageal varices, hepatic encephalopathy, ascites and hyperbilibubinemia in patients with CHC-CLC were much lower than(P<0.05), while the peripheral white blood cell (WBC) counts, hemoglobin concentration, platelet counts, serum albumin levels and prothrombin time activity were significantly higher than in patients with CHC-DLC(P<0.05); at the end of 48 week follow-up, three patients (11.1%) with CHC-DLC died; the EVR, EOT, SVR24 and SVR48 in patients with CHC-CLC were 94.4%, 100.0%, 100.0% and 100.0%, superior to 83.3%, 100.0%, 83.3% and 75.0%(P<0.05) in patients with CHC-DLC; in patients with CHC-CLC, serum alanine aminotransaminase level was 32(18, 40)U/L, peripheral WBC count was 4.1(3. 2, 7.7)×10⁹/L, platelet count was 104(90, 381)×10⁹/L, all significantly different as compared to [55(35, 62)U/L, 3.0(2.7, 5.0)×10⁹/L and 72(54, 115)×10⁹/L, respectively, P<0.05] in patients with CHC-DLC; during the antiviral treatment period, the untoward reactions were found in 4 patients with CHC-CLC and in 8 patients with CHC-DLC, including abdominal distension, anorexia, fatigue, throbbing headache and transient hypertension, which didn't influence the treatment. Conclusion The oral administration of SOF and VEL plus or not plus ribavirin in treatment of patients with with CHC-CLC and CHC-DLC is efficacious and safety, which warrants further clinical investigations.

Key words: Liver cirrhosis, Hepatitis C, Direct acting antivirals, Sofosbuvir, Velpatasvir, Therapy