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AIM: Non-bioartificial liver has been applied to clinic for quite a long time, but the reported efficacy has been very different. The aim of this study was to compare the efficacy and safety of hemoperfusion adsorption, plasma exchange and plasma exchange plus hemoperfusion adsorption in treatment of severe viral hepatitis.METHODS: Seventy-five patients with severe viral hepatitis were treated with hemoperfusion adsorption therapy (24cases), plasma exchange therapy (17 cases) and plasma exchange plus hemoperfusion adsorption therapy (34 cases).The data of liver function, renal function, blood routine test,prothrombin time (PT) and prothrombin activity (PTa) preand post-therapy were analyzed.RESULTS: Clinical symptoms of patients improved after treatment. The levels of aminotransferase, total bilirubin,direct bilirubin decreased significantly after 3 therapies (P＜0.05 or P＜0.01). PT, the level of total serum protein decreased significantly and PTa increased significantly after plasma exchange therapy and plasma exchange plus hemoperfusion adsorption therapy (P＜0.05 or P＜0.01). The side effects were few and mild in all patients.CONCLUSION: Three therapies were effective in the treatment of severe viral hepatitis. Plasma exchange therapy and plasma exchange plus hemoperfusion adsorption therapy are better than hemoperfusion adsorption therapy.