OBJECTIVES: To examine the economic burden and health care utilizations of patients diagnosed with the hepatitis B virus (HBV) in the U.S. veteran population. METHODS: A retrospective database analysis was performed using the Veterans Health Administration (VHA) Medical SAS datasets from October 1, 2008 to September 30, 2012. Patients diagnosed with HBV were identified using International Classification of Disease 9th Revision Clinical Modification (ICD-9-CM 070.22, 070.23, 070.32, 070.33, V02,61) diagnosis codes. The first diagnosis date was defined as the index date. A group of patients of the same age, region, gender and index year but without HBV infection were identified and matched by baseline Charlson Comorbidity Index (CCI) as the comparison group. A 1-year continuous health plan enrollment was required before and after the index date for both groups. Study outcomes, including health care costs and utilizations, were compared between the HBV and comparator groups using 1:1 propensity score matching. RESULTS: A total of 9,718 patients were identified for the HBV and comparison cohorts. After applying a 1:1 matching, a total of 3,093 patients were matched from each cohort, and the baseline characteristics were proportionate. Patients diagnosed with HBV infection were more likely to report higher health care utilizations, including inpatient (28.74% vs. 3.3%, p<0.01), emergency room (25.67% vs. 8.3%, p<0.01), physician office (98.60% vs. 62.75%) and pharmacy visits (88.23% vs. 63.65%, p<0.01). The risk-adjusted health care costs were also higher for patients infected with HBV due to increased inpatient ($10,481 vs. $804, p<0.01), emergency room ($382 vs. $80, p<0.01), physician office ($4,635 vs. $1,678, p<0.01), and pharmacy visits ($1,166 vs. $398, p<0.01) resulting in higher total costs ($16,909 vs. $3,045, p<0.01) relative to the comparator cohort. CONCLUSIONS: During a period of 12 months, VHA patients diagnosed with HBV reported higher health care utilization and costs than their matched controls.