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Objective To evaluate the performance of Hepatitis C virus (HCV) core antigen and HCV RNA PCR in the determining of the efficacy of HCV antiviral therapy in patients infected with HCV. Methods HCV core antigen and HCV RNA were measured in sera of 35 chronic HCV infected Chinese patients. Concentrations of HCV core antigen and HCV RNA were analyzed at 5 time points before, during and at the end of antiviral therapy. Results This study showed that the HCV core antigen and HCV RNA concentrations in 35 HCV patients were significantly correlated. Decrease of HCV core antigen and HCV RNA concentrations at the 4th, 12th,24th and 48th week were observed during the antiviral therapy. However,HCV core antigen levels at week 12 and 24 of therapy were significantly lower than those at week 4 (P 0. 05). HCV core antigen testing may be advantageous in some cases,in particular,the low levels of HCV core antigen at week 4 may be predictive of satisfactory outcome of treatment. Conclusions HCV core antigen represents a stable and sensitive marker of viral replication and could be used to monitor the clinical efficacy of HCV antiviral therapy.