OBJECTIVE: The objective of this study was to assess patient-derived utility estimates for clinical and histological health states representing variation in chronic hepatitis C (CHC) associated disease severity. METHODS: A total of 428 patients with CHC participated in a cross-sectional interview-based study using the utility measurement methods rating scale (RS) and EuroQoL (EQ-5D). Current clinical and histological health status was assessed and assigned to an ordinal scale representing ascending severity of disease. Rating scale was transformed by the Torrance transformation. Multivariate stepwise regression with a log-transformed outcome was used to calculate utilities for the health states adjusted for age, gender, viral status, co-morbidity, and short-term effect of current antiviral medication. RESULTS: Quality-of-life values based on RS (r=0.24; p<0.001) and EQ-5D (r=0.13; p<0.019) showed significant correlation with the severity of disease scale. Overall, RS resulted in higher utilities than EQ-5D. Depending on health state and instrument, utilities ranged from 0.92 (mild hepatitis, RS) to 0.72 (hepatocellular carcinoma, EQ-5D). Short-term relative utility reduction during the time of treatment with combination therapy was 15% for RS (p<0.001) and 14% for EQ-5D (p<0.001). RS and EQ-5D were highly and significantly correlated (r=0.64, p<0.001) suggesting that the results are robust. CONCLUSION: Patients with CHC appear to experience a lower quality of life compared to the general population. This study suggests that the Torrance transformation of the rating scale or EuroQoL from patient reports are feasible and robust instruments for assessing patient preferences regarding quality of life. These results can be used in cost-effectiveness analyses in studies of patients with chronic hepatitis C.