IJOTM 2008-6490 6 2 2015 04 26 Treatment of Recurrent Hepatitis C Genotype-4 Post- Liver Transplantation with Sofosbuvir plus Simeprevir 86 90 EN Mustafa Ascha Mona Ascha NN Zein N Alkhouri B Eghtesad K Abu-Elmagd T Diago IA Hanouneh Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio, United States. Hanouni2@ccf.org 2015 03 26 Hepatitis C virus (HCV) infection remains a leading indication for orthotopic liver transplantation (OLT) worldwide. Recurrence of HCV following OLT is universal. There is scarcity of data on the post-OLT treatment of HCV genotype-4—the predominant genotype in North Africa and the Middle East. Herein, we present three patients who have experienced HCV genotype-4 recurrence post-OLT. All three patients were interferon-naive and were treated with simeprivir (SIM) and sofosbuvir (SOF) combination therapy for 12–24 weeks. The data from this case series show that SIM+SOF are well-tolerated and effective for achieving viral clearance in HCV genotype-4 post-OLT patients. Given the limited nature of a case series, further research must be pursued regarding post-OLT HCV genotype-4 responses to direct-acting anti-viral therapy.