Background and study aim:: Reports have found an association between B cell non-Hodgkin lymphomas (NHL) and Hepatitis C virus (HCV) infection. However, data on acute exacerbation and reactivation of chronic HCV infection following chemotherapy are very limited. We studied the efficacy of ribavirin to prevent hepatitis reactivation in HCV-infected patients treated for NHL. Patients and methods: This study was carried out at Medical Oncology & Hematology  Department , Zagazig University Hospitals. It included 57 patients with  B-cell NHL who were naïve to chemotherapy,  among them 24 patients  were positive for HCV and 33 patients were negative for HCV (group C). The HCV positive group were subdivided into 11 patients who received ribavirin (group A) and 13 patients did not receive ribavirin (group B). Routine investigations for NHL were done, HCV RNA was measured for HCV positive patients before  and after the end of chemotherapy. Results :HCV infection occurred in 42% of patients with B cell NHL. Acute hepatic enzyme exacerbation occurred in 8 (14%) of all patients with the highest percentage was 29.2 % among HCV infected patients (7/24), while only one patient (3%) in the HCV negative group (p= 0.007). Among the 24 NHL patients with  HCV positivity, we compared group A  versus group B during chemotherapy  as regards to  hepatic enzyme flare, it was ( 27% & 30%, respectively, p= 0.6). Five (20.8%) of 24 NHL patients with HCV positivity developed HCV PCR reactivation; 2 patients of group A and 3 patients of group B  (18.2% & 23.1%, respectively, p= 0.58). The outcome was comparable between the three groups. Conclusion : The frequency of HCV infection in patients with B cell NHL is higher than in the general population. Acute exacerbation and reactivation of chronic HCV infection occur in a sizeable subset of patients with NHL during chemotherapy. The use of ribavirin did not decrease  hepatic enzyme flare or  HCV PCR reactivation during chemotherapy.