To investigate the effectiveness and safety of coblopasvir hydrochloride combined with sofosbuvir （CLP/SOF） in the treatment of patients with chronic hepatitis C （CHC） and those with genotype 3b in terms of virologic response rate，changes in liver and renal function parameters，and adverse events，and to provide a reference for clinical diagnosis and treatment.

The patients with CHC who were admitted to Maanshan Fourth People’s Hospital from March 1，2023 to July 31，2024 were enrolled and treated with CLP/SOF for a course of 12 weeks. Follow-up assessments were conducted at weeks 4，8，and 12 of treatment and at 12 weeks after the end of treatment，and related data were collected，including HCV RNA，routine blood test results，and liver and renal function parameters. Sustained virologic response at 12 weeks after treatment （SVR12） and safety profile were evaluated. The Friedman test was used for comparison of liver and renal function parameters，routine blood test results，and liver fibrosis score at different time points.

A total of 107 CHC patients treated with CLP/SOF were enrolled，with an age of 22 — 92 years，and there were 55 male patients. The predominant genotypes were 1b （46.73%） and 3b （28.97%）. Comorbidities mainly included liver cirrhosis （15 patients），fatty liver disease （27 patients），syphilis （15 patients），HBV infection （8 patients），and HIV infection （2 patients）. The overall SVR12 rate was 100% （107/107），with an SVR12 rate of 100% for subgroups with different genotypes and those with liver cirrhosis，fatty liver disease，syphilis，HBV infection，or HIV infection. The patients with HCV genotype 3b comorbid with liver cirrhosis，fatty liver disease，syphilis，HBV infection，hypertension or diabetes also achieved an SVR12 rate of 100%. After CLP/SOF treatment，the patients showed significant reductions in the levels of the liver function parameters alanine aminotransferase，aspartate aminotransferase，total bilirubin，and hemoglobin （all P<0.001） and significant reductions in the liver fibrosis scores fibrosis-4 and aspartate aminotransferase-to-platelet ratio index （both P<0.001）. The median creatinine level was 66 μmol/L before treatment，which decreased to 52 μmol/L at week 12 of treatment （P<0.001）. No adverse events were reported.

Patients with CHC achieve a high SVR12 rate and significant improvements in liver function parameters and liver fibrosis markers after treatment with the CLP/SOF regimen，and this regimen has no significant impact on renal function and shows a favorable safety profile. Therefore，it holds promise for clinical application.