We investigated lipid metabolism in nine patients with chronic hepatitis C virus (HCV), not responded by previous interferon therapy (IFN), undergoing double filtration plasmapheresis (DFPP) and peginterferon plus ribavirin (PEG·Rib) combination therapy. Three patients were non-responder of previous IFN monotherapy and 6 were PEG·Rib. HCV RNA became negative within 24 weeks in 5 out of 9. In the HCV RNA negative group, Triglyceride (TG) and Total-Cholesterol (T-Chol) or LDL-Chol levels increased gradiently after DFPP and were higher than those before treatment, but not in HCV positive group. DFPP plus PEG·Rib combination therapy might not only produce a reduction of HCV but also improve the environment of lipid metabolism effective for PEG·Rib during the early stage of treatment.