Hepatitis C virus (HCV) infection is a major health problem throughout the World. Egypt has the highest worldwide prevalence of HCV (10-20%). The combination of peginterferon and ribavirin can achieve sustained virologic response in over 50% of those treated. However, adherence to treatment is critical to maintain high rates of virologic clearance. Unfortunately, peginterferon plus ribavirin therapy can be associated with side effects, some of which may lead to dose reduction, premature discontinuation of the drug, and subsequent treatment failure. is to detect and to manage the hematological side effects of pegylated interferon/ribavirin therapy in chronic HCV in Egyptian patients. This study was done in Sohag city on 500 Egyptian patients who are candidates for pegylated interferon/ ribavirin therapy for chronic HCV. All patients were treated with peginterferon alfa 2a (180 mcg /week) or peginterferon alfa 2b (1.5 mcg/kg weekly) subcutaneously plus oral ribavirin in a dose ranging from 800-1200 mg/day for 48 weeks. Baseline pretreatment assessment included quantitative HCV-PCR, liver and kidney functions, complete blood picture, T3 and T4 levels, abdominal ultrasonography, liver biopsy, fundus examination and ECG. Liver functions and complete blood picture were done at the 4 th , 12 th , 24 th , and 48 th weeks. HCV- PCR was followed up at the 12 th , 24 th , and 48 th weeks. During the period of our study, 153 (30.6%) of the studied patients had decrease in hemoglobin level to 10 g/dl, while severe anemia with hemoglobin level less than 8.5 g/dl was found in 33 (6.6%) patients. Reduction of total leucocytic count to 2000 cells/mm 3 was found in 49 (9.8%) patients, while severe neutropenia with neutrophils count less than 750 cells/mm 3 was found in 12 (2.4%) patients. Asymptomatic thrombocytopenia with platelets count from 50000 to 150000/mm 3 was found in 141 (28.2%) patients, while severe thrombocytopenia with platelets count less than 50000/mm 3 was found in 3 (0.6%) patients. the hematological side effects of pegylated interferon and ribavirin are anemia, leucopenia, and thrombocytopenia in 30.6%, 9.8% and 34% of the patients during the course of the treatment. These side effects can be managed by dose reduction or stoppage and by administration of erythropoietin and Granulocyte colony-stimulating factor (G-CSF).

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