Objective To study the different courses of pegylated interferon and antiviral drugs in patients with recurrent hepatitis C and the related factors. Methods Two hundreds patients with recurrent hepatitis C treated in our hospital between February 2013 and January 2014 were divided into group A (treatment for 12 months) and group B (treatment for 18 months) based on the random number table. They were treated with pegylated interferon plus Ribavirin combination therapy. The efficacy, alanine aminotransferase, platelet count and neutrophils were compared,and the relevant factors influencing effect of the drug treatment were analyzed. Results In the group A, sustained virologic response (SVR) was found in 71 cases, recurrence in 13 cases, no response in 3 cases; in the group B. SVR appeared in 74 cases, recurrence in 6 cases, no response in 4 cases. There was no significant difference in the SVR rate or non-response rate (P > 0.05), but the recurrence rate in the group B was significantly lower than that in the group A (P < 0.05). Before treatment, the liver function indexes of the two groups were not significantly different (P > 0.05).After treatment, alanine aminotransferase, platelet count and neutrophils of the group B were lower, among which alanine aminotransferase and platelet count were significantly different from those of the group A (P < 0.05). The patients’ age, sex, blood transfusion infection and history of interferon usage had no significant differences (P > 0.05).Hepatitis C virus (HCV) genotype, viral load and SVR rate in the patients with drug reduction or discontinuation had significant differences (P < 0.05), and were the factors influencing the effect of pegylated interferon and antiviral therapy for patients with recurrent hepatitis C. Conclusions Continuous pegylated interferon and antiviral treatment for 18 months can significantly improve liver function and reduce the recurrence rate of hepatitis C, but does not have improvement in the patient’s virologic response. Its therapeutic effect is influenced by HCV genotype, viral load, drug reduction or discontinuation.