SVR is expected at the time of the meeting. Safety: There was no further decompensation during the treatment. Mean MELD score before and during treatment was not different (mean MELD before starting treatment is 11.6 and peak MELD during treatment is 13.6). None of the patients were hospitalized

during the therapy. Six patients developed hemoglobin levels < 10 gm/dl and one patient had Hb < 8 gm /dL. None of the patients required red cell transfusion. The average bilirubin during the treatment course was 2.5 mg/dl (range: 0.4-5.5 mg/dl). Conclusion: Rapamycin mouse The simeprevir and sofosbuvir combination was well tolerated by patients with decompensated cirrhosis. The early virological response is similar to the reported data

in compensated cirrhotic patients. Disclosures: Sanjaya K. Satapathy – Advisory Committees or Review Panels: Gilead Satheesh Nair – Advisory Committees or Review Panels: Jansen; Speaking and Teaching: Gilead The following people have nothing to disclose: Shilpa Lingala, Nader Dbouk Background: There is no data available on the use of sofosbu-vir or simeprevir in hepatitis c patients with severe renal insufficiency or dialysis. Aim: To describe our experience with the use of sofosbuvir based regimen in patients with GFR < 30ml/ min who urgently need hepatitis c treatment. Methods: We collected data on 4 male patients with HCV genotype 1 (50% 1a), mean age 58 years who had severe renal insufficiency defined by GFR < 30ml/min or those who are on dilaysis. Two cirrhotic patients check details with ESRD on dilaysis

were bering evaluated for combined liver kidney transplant who had normal hepatic synthetic function (mean albumin 4.3, INR 1, Bilirubin 0.5) and were disinclined to undergo liver transplantation (LT) were started on sofosbuvir 400mg every other day and simeprevir 150 mg every day. One liver transplant recipient developed fibrosing cholestatic hepatitis (FCH) within 3 months post LT with ascites, bilirubin 27 and severe renal impairment requiring dialysis and was started on compassionate sofosburvir 400mg daily and ribavirin 200mg every other day. Fourth patient see more was a post liver-kidney transplant recipient who developed acute antibody mediated rejection of the kidney requiring intense immunosup-pressive therapy and thus was started on sofosbuvir 400mg every other day and simeprevir 150mg daily. Results: The patient with FCH has attained SVR 24 and is cured of HCV. His hepatic function normalized and his GFR also improved significantly to 55ml/min without the need for further dialysis at the end of treatment. Two patients were undetectable on treatment and one patient had low level viremia of 169 IU at week 4. Conclusion: We present the first case series of 4 HCV genotype 1 patients with severe renal insufficiency (GFR < 30), 3/4 on dialysis who are undergoing treatment with sofosbuvir based regimen.