OBJECTIVES: To assess the economic evaluation of short and longer term antiviral treatments of HBeAg-positive and HBeAg-negative chronic hepatitis B from the perspective of the Chinese healthcare system. METHODS: Two 10-health state Markov models were developed to estimate long term cost and effectiveness of different treatments of CHB, one for HBeAg-positive and one for HBeAg-negative . Incremental cost effectiveness analysis was then carried out. RESULTS: For HBeAg-positive model, in comparison with no antiviral treatment, lamivudine administered for 1 year was a highly cost-effective short-course treatment for  CHB. However, of the treatments evaluated, lamivudine plus adefovir as rescue medication or adefovir plus lamivudine as rescue medication administered for 5 years resulted in a more sustained decrease in the rate of disease progression. . In comparison with 1 year lamivudine treatment, the incremental cost per QALY for treatment with lamivudine plus adefovir or adefovir plus lamivudine as rescue medication for 5 years was CNY 25,115 and 35,577 respectively, which are 55.2% and 36.5% lower than the estimated international threshold value for China. For HBeAg-negative model, the most cost-effective short term treatment for HBeAg-negative CHB was lamivudine administered for 1-year in comparison with no antiviral treatment. However, of the treatments evaluated, lamivudine plus adefovir as rescue medication or adefovir plus lamivudine as rescue medication administered for 5 years resulted in a more sustained decrease in the rate of disease progression. In comparison with 1 year lamivudine treatment, the incremental cost per QALY for treatment with lamivudine plus adefovir or adefovir plus lamivudine as rescue medication for 5 years was CNY 16,465 and 17,884 respectively, which are 70.6% and 68.1% lower than the estimated international threshold value for China. CONCLUSIONS: In comparison with no antiviral treatment, lamivudine administered for 1 year was a highly cost-effective short-course treatment. Longer duration antiviral treatments, lamivudine plus adefovir or adefovir plus lamivudine as rescue medication were both cost-effective strategies, resulting in a more sustained decrease in the rate of disease progression.