enrolled participants were treated orally with SOF plus a fixed dose combination of OBV/PTV/r plus RBV.

Enrolled participants were treated orally with SOF plus a fixed dose combination of Sofosbuvir/Ombitasvir/Paritaprevir/ Ritonavir plus Ribavirin (OBV/PTV/r plus RBV), which was administered orally based on the participants' tolerability. The primary end point was a sustained virological response (HCV RNA level < 15 IU/ mL), observed 12 weeks after the end of the treatment (SVR12).

Inclusion Criteria:

• The experienced participants who were treated previously with (SOF/DCV) , (SOF/SMV), (SOF/RBV), or (SOF/pegINF/RBV).
• The presence of compensated liver cirrhosis was documented by ultrasonographic examination, liver biopsy, results of Fibroscan or FIB-4 score, and laboratory markers, like FIB-4 > 3.25 (advanced fibrosis or cirrhosis), albumin < 3.5, total bilirubin > 1.2, and also confirmed by clinical characteristics such as lower limb edema, splenomegaly, esophageal varices.

Exclusion Criteria:

• liver disease of non-HCV GT4 etiology, coinfection with hepatitis B or HIV
• poorly controlled diabetes (HbA1C > 8)
• participants, hepatocellular carcinoma, a history of extrahepatic malignancy in the 5 years prior to the study
• renal failure
• evidence of hepatic decompensation
• blood picture abnormalities such as anemia (hemoglobin concentration of < 10 g/dL)
• thrombocytopenia (platelets count < 50,000 cells/mm3).
• major severe illness such as congestive heart failure and respiratory failure.