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Background Mixed cryoglobulinemia(MC)is one of the most common and severe symptoms in chronic hepatitis C patients.The aim of this study was to investigate whether mixed cryoglobulinemia is a factor associated with sustained virological response in chronic hepatitis C patients treated with combination therapy of pegylated interferon alpha-2a and ribavirin.Methods This is a single-center study including 57 chronic hepatitis C patients who received combination treatments of pegylated interferon alfa-2a and ribavirin.Serum cryoglobulin was detected by cryoprecipitation prior to treatment.Serum hepatitis C virus(HCV)RNA levels were checked before treatment,during the fourth and 12th week of treatment,and during the 24th week after cessation of treatment.The genotype of HCV was determined at baseline.Logistic regression analysis was used to assess the factors associated with sustained virological response.Results Twenty-five patients were with MC(43.9％).Twenty-four weeks after cessation of antiviral treatment,sustained virological response achievement in MC+patients was significantly lower than that in MC-patients(32.0％ vs.75.0％,P=0.001).Univariate Logistic regression analysis and multivariate Logistic regression analysis found that only MC(odds ratio:6.375;95％ Cl:1.998-20.343,P=0.002)was negatively associated with sustained virological response achievement.Conclusion MC is an independent factor negatively associated with sustained virological response in chronic hepatitis C patients treated with pegylated interferon alpha-2a and ribavirin.