McCaughan GW, et al. - The virological response and effect of viral clearance were investigated in patients with decompensated hepatitis C cirrhosis all with MELD scores ≥15 following sofosbuvir/daclatasvir ± ribavirin. In advanced liver disease, sustained viral response at 12 weeks (SVR12) rates with sofosbuvir/daclatasvir were lower than in compensated disease. Treatment improved MELD and Child-Pugh in most patients, however, a significant proportion would die or require transplantation. It could be better to delay treatment until post-transplant in those with MELD ≥20.