Background: the results of studies on the efficiency and safety of direct-acting antivirals became available only in recent years. Data from two randomized clinical trials (RUBY-1 and C-SURFER) allowed the use of a combination of Grazoprevir-Elbasvir and Ombitasvir-Paritaprevir-Ritonavir in patients with hepatitis C and CKD on hemodialysis. However, because of the high cost and absence of government’s medical insurance, they are not available to most patients. Therefore, generic drugs became an alternative in Kyrgyzstan. One of them is a combination of Sofosbuvir and Ledipasvir. The accumulated data from different single-centered studies suggests safety and effectiveness of its use in the treatment of patients with hepatitis C and End Stage Renal Disease. Aim of this article is to show the result of the safe and effective use of an antiviral drug of direct action in a patient on hemodialysis with systemic vasculitis on the background of maintenance therapy with glucocorticosteroids. Methods: we report on the 55-year female patient on maintenance hemodialysis with Systemic vasculitis and Hepatitis C, who received combination of direct acting anti-viral drugs such as Sofosbuvir and Ledipasvir. Results: HCV RNA was negative after 2 weeks of treatment. Therapy was well tolerated without adverse effects. There was no necessity to correct HD or main disease’s treatment. Sustained virological response was achieved after 24 weeks. Conclusion: full dosage of Sofosbuvir-Ledipasvir therapy for hepatitis C patient on HD with systemic vasculitis was effective and safe without discontinuation or severe side effects. However, final conclusion about safety and efficacy of such treatment must be based on prospective multicenter studies.