Few data are available concerning the roles of polymorphisms of inosine triphosphatase (ITPA) gene and ribavirin (RBV) transporter genes in the prediction of RBV-induced anemia among Egyptians with chronic hepatitis C (CHC). Genotyping of 3 ITPA gene variants and 2 variants of RBV transporter genes has been performed in 123 patients under pegylated interferon-α/ribavirin treatment. The baseline hemoglobin and ITPA rs1127354 CA/AA have been found as predictors of anemia at 4, 8 and 12 weeks of RBV therapy. In addition, ITPA rs7270101 AC/CC and age predicted anemia after 12 weeks of therapy. In conclusion, the ITPA variant rs1127354C>A significantly predict RBV-induced anemia during the first 3 months of treatment and it is recommended to be assessed before RBV administration.