Hyperleptinemia, hyperferritinemia and hyperuricemia have been implicated in hepatic inflammation and fibrosis and assumed to be predictors of poor response to antiviral therapy. The aim of study was to evaluate the role of serum leptin, ferritin and uric acid in progression of chronic hepatitis C (CHC) disease and their role in detection of virological response to combined antiviral therapy (pegylated interferon PEG-IFN-α/ribavirin RBV). Study design was a prospective study; conducted on 40 patients with CHC infection eligible for treatment with combined antiviral therapy before the start of therapy and 30 healthy volunteers as controls. Patients with chronic liver disease due to other causes were excluded from the study. All patients and controls had thorough clinical evaluation, abdominal ultrasonography, complete blood count (CBC), liver enzymes (AST/ALT), total bilirubin in addition to leptin, ferritin and uric acid serum levels. Plasma HCV-RNA viral load by real-time polymerase chain reaction (PCR) and liver biopsy using Metavir scoring system were done for HCV patients only. We compared levels of serum leptin, ferritin and uric acid between patients and controls. We estimated serum leptin and ferritin sensitivity, specificity and accuracy in both responders and non-responders to antiviral treatment. Study findings were as follows: higher concentrations of serum leptin and ferritin were predictive factors for failure of combined antiviral treatment and correlated with inflammatory activity and advanced liver fibrosis. Serum uric acid level was not significantly associated with inflammatory activity, stage of hepatic fibrosis and interferon treatment failure. In conclusion CHC was associated with higher serum leptin and ferritin levels. High serum leptin and ferritin levels were negative predictors for response to combined antiviral treatment in CHC patients. Serum leptin had higher sensitivity, specificity and accuracy than serum ferritin; so leptin could be considered better than ferritin in prediction of response to antiviral therapy in CHC patients.