OBJECTIVES: Antiviral therapy remains an important treatment strategy for chronic hepatitis B (CHB) in China. However, multiple antiviral strategies – interferon, lamivudine, adefovir, and their sequential use – have caused difficulties for health decision-makers in selecting cost-effective treatments, given their high prices and long-term interventions. This study assessed cost-effectiveness of current available treatment alternatives for patients with CHB in China. METHODS: A cost-utility analysis was conducted from the Chinese healthcare-sector perspective. We developed a decision-analytic model to simulate a 1-year disease progression. Markov model was used to simulate life-time outcomes, based on 1-year results. The model was validated through discussion with leading hepatologists in China. Seven treatment alternatives, including no antiviral treatment, were considered for patients with HBeAg-positive CHB. The data on disease transition probabilities were primarily obtained from the randomized trials and meta-analyses, and validated by the clinician experts panel. The data on utility of different diseases states were derived from a published study on Chinese patients. The resources use was obtained from a literature, and adjusted based on the expert panel's recommendations. The unit prices of resources 2006 were obtained from national and provincial registries. The costs were presented in US dollars. A rate of 5% was used to discount the costs. RESULTS: The base-case analysis showed that, of these seven treatment options, no antiviral therapy was dominated by all the antiviral treatment options. Interferon-adefovir sequential use dominated all the other alterative antiviral treatments, with US$562.3 per QALY gained (US$15215.8 for 27 QALYs). When the transition probability of HBeAg seroconversion in patients using adefovir was less than 0.157, and that of relapse rate higher than 0.032, lamivudine-adefovir strategy would be the dominant one. CONCLUSION: Interferon-adefovir appeared to be the most cost-effective strategies for CHB in China. However, clinical effects of adefovir might affect the robustness of results.