OBJECTIVES: The objective of this study was to evaluate sick leave and disability pension in chronic hepatitis C patients (CHC) compared with matched general population comparators. A secondary objective was to examine sick leave and disability pension in relation to CHC diagnosis. METHODS: We performed a register-based cohort study using the Swedish National Patient Register to identify both working-age patients with CHC in 2012 (n=32,021) as well as CHC patients diagnosed between 1999 and 2007 (n=19,362). Sick leave and disability pension data were retrieved from Statistics Sweden (1994–2012). Up to 5 age-, sex-, and place of residence-matched individuals from the general population were sampled for each CHC case. RESULTS: In 2012, 14% of the CHC patients had ≥1 registered sick leave episode compared with 10% in the matched general population comparator cohort. For disability pension benefits, the respective results were 30% compared with 8%. Overall, 58% of patients with CHC compared with 83% in the matched general population comparator cohort did not have any registered work days lost in 2012. Also, 29% of CHC patients were absent >360 days compared with 9% in the matched general population comparator cohort (p<0.001). The mean total annual days of work lost in 2012 were 126 days in the CHC patient cohort compared with 40 days in the matched general population comparator cohort. Annual days lost increased from a mean of 86 days five years before diagnosis to 136 days during the year of diagnosis. Five years after diagnosis/index date, 34% of CHC patients were almost fully work disabled compared with 11% in the matched general comparator cohort (p<0.001). CONCLUSIONS: The results from the present study suggest that CHC negatively impacts both work absence and the need for disability pension compared with the matched general population comparators in Sweden.