Introduction: Treatment of HCV infection is a rapidly evolving field. Clinical trials revealed a significant improvement in sustained viral response (SVR) compared to prior direct-acting anti-viral regimens. However, limited or no data exists in important subgroups of patients including those with prior treatment failure, cirrhosis, liver transplantation or other co-morbidities. It is essential to understand the safety and efficacy of sofosbuvir-based therapies in real-world settings.We aimed to identify HCV treatment outcomes, describe the differences in patient characteristics which influence SVR rates. Methods: In this retrospective study, patients who were treated with sofosbuvir-based therapies between Oct 2014 to March 2015 were reviewed for clinico-demographic characterisitcs, laboratory values and adverse events. Total of 494 patients were treated with sofosbuvir-based therapies. 207 patients, who completed their treatment with at least 12 weeks follow up after treatment, were included for analysis. Results: Mean age is 59 years; 65% were male. There were 55% genotype 2, 34% genotype 1 and 19% genotype 3 patients. 44% had cirrhosis, 38% had prior treatment failures and 9.7% were liver transplant recipients. Overall SVR at 12 weeks (SVR12) was 80%. Overall SVR 12 for genotype 1 was 69%: treatment naive: 84%, prior treatment failure: 62%, non-cirrhotic: 89% and cirrhotic: 68% respectively. Overall SVR 12 for genotype 2 was 90%: treatment naive: 92%, prio treatment failure: 87%, non-cirrhotic: 93% and cirrhotic 84%. Overall SVR 12 for genotype 3 was 53%, treatment naive: 43%, prior treatment failure: 58%, non-cirrhotic: 40% and cirrhotic: 57%. Overall SVR 12 among liver tranplant recipients were 75%. The most common 3 side effects were fatigue, arthalgia and nausea. 3% discontinued treatment due to intolerable side effects. Serious adverse events requiring hospitalizations were due to pneumonia, abdominal wall abscess, chest pain and syncope. Conclusion: It was observed that real-world SVR rates are lower compared to clinical trials. Patient characteristics that influence SVR rates are male gender, cirrhosis, prior treatment failure and high baseline viral load. Rate of side effects, serious adverse events wer comparable to clinical trials. Overall, patients appear to be compliant and tolerate treatment well. In conclusion, our study highlighs the differences in outcomes between clinical trials and real-world clinical practice.Figure 1Figure 2Figure 3