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Abstract HCV infection is one of the main causes of chronic liver disease worldwide . The long-term impact of HCV infection is highly variable, ranging from minimal histological changes to extensive fibrosis and cirrhosis. Liver cirrhosis follows an indolent course and eventually patients’ disease condition progress without any gross manifestation to the complications of liver decompensation such as variceal bleeding from portal hypertension, ascites , spontaneous bacterial peritonitis, hepatorenal syndrome, hepatic encephalopathy and cardiopulmonary complications like porto-pulmonary hypertension and hepato-pulmonary syndrome that responsible for significant morbidity and mortality in patients with liver cirrhosis and accounts for most indications of liver transplantation . Direct-acting antiviral agents (DAAs) have revolutionized the treatment of hepatitis C virus (HCV) infection over the last 5 years. As a result of better understanding of the HCV life cycle, specific DAAs have been developed for HCV that are able to target the viral proteins implicated in replication of the virus. Treatment of hepatitis C is now extremely effective, tolerable and requires a short duration of intake of oral agents. Sustained virologic response to interferon-free therapies with various combinations of direct -acting antivirals ameliorates HCVinduced portal hypertension , significantly reduces fibrosis |