Background and study aim: The current standard of care (SOC) for chronic hepatitis C (CHC) in Egypt is pegylated interferon and ribavirin (PEG-INF/RBV) for 48 weeks, which is expensive, can be difficult to tolerate and with high failure rate. Additional information about predicting sustained virologic response (SVR) may be helpful in making proper decisions of treatment. This is a retrospective observational cohort study which was designed to identify predictors of SVR to PEG-INF/RBV among a cohort of Sharkian patients in Egypt Patients and methods: 2991 patients with CHC fulfilling all inclusion and exclusion criteria for treatment were enrolled in this study. Patients were allocated randomly to treatment with either PEG-INF α2a/RBV (67.8%) or PEG-INF α2b/RBV (32.2%). Virologic monitoring was planned to be tested basically and at weeks 12, 24, 48 and 72 weeks after initiation of treatment. Results: Analysis of data could be applied to 795 (26.6%) patients of the cohort because of their adherence to protocol and availability of treatment and follow up data. The remaining participants of the study (73.4%) were excluded because of lack of essential data and drop out for various reasons. Overall SVR was encountered in 404 (50.8%) patients and in 54.9% and 44.2% for patients treated with PEG-INF α2a and PEG-INF α2b respectively ( p< 0.0001 ). Responders had statistically significant lower levels of fasting blood sugar, ALT, AST, indirect bilirubin, α fetoprotein, hemoglobin, stage of liver fibrosis and HCV RNA and higher values of alkaline phosphatase,serum albumin, prothrombin time , absolute neutrophil and platelet counts. In multivariate linear regression analysis, early virologic response (EVR) and receiving PEG-INF α2a (rather than PEG-INF α2b) were predictors of SVR. Conclusion: Overall SVR among Sharkian patients with CHC, treated with SOC therapy is 50.8%. EVR is the best independent predictor of SVR. The form of PEG-INF may also predict the treatment response. None of the initial pretreatment variables could predict the SVR to treatment with the current SOC for CHC.