This article reviews the haematological complications of the antiviral treatment of chronic hepatitis C virus infection with a combination of pegylated and nonpegylated alpha-2a and alpha-2b interferons plus ribavi-rin. The major side effect of combination therapy is haemolytic anemia which usually develops 4—8 weeks after initiation of treatment, and is ribavirin dose-dependent. The main risk factors of haemolytic anemia due to ribavirin in combination therapy are: higher baseline haemoglobin levels and a lower platelets count, dose of alpha-interferon administered, higher iron saturation, haptoglobin phenotype, renal function (lower baseline creatinine clearance), age (older patients are more at risk) and sex (males are more at risk). Ove-rall risk of ribavirin-induced haemolytic anemia was 9 %. Epoetin alpha seems to be a very promising drug for the treatment of haemolytic anemia and ribavirin dose maintenance.

        Key words: haemolytic anemia, ribavirin, epoetin alpha, chronic hepatitis C.