OBJECTIVE: Approximately 8% of people in Hong Kong are chronically infected with the hepatitis B virus (HBV). Without treatment, infected individuals may progress through increasingly severe disease states before death. Utility weights are useful for estimating the combined impact of morbidity and mortality and estimate quality adjusted life years (QALYs) in cost-effectiveness analyses. The objective was to elicit utility weight estimates associated with six hepatitis B-related disease states. METHODS: Three hepatologists characterized the typical effects of HBV symptoms on health-related quality of life. We elicited preferences from 100 uninfected subjects and 100 subjects chronically infected with HBV in Hong Kong using: 1) a visual analogue scale (VAS) based on a `feeling' thermometer anchored between 0 (death) and 1 (perfect health), and 2) standard gamble (SG) utility weights using probability wheels with 2-color pie charts for the relative probabilities of perfect health and death. RESULTS: For infected subjects, the mean age was 45 years (range: 18 to 80) and 79% were male. Mean utility weights elicited from infected subjects using SG were: 0.69 (95% confidence interval: 0.63-0.74) for chronic hepatitis B; 0.71 (0.66-0.77) for compensated cirrhosis; 0.27 (0.22-0.32) for decompensated cirrhosis; 0.64 (0.58-0.69) for first year after liver transplant; 0.71 (0.65-0.76) for subsequent years after liver transplant and 0.36 (0.30-0.42) for hepatocellular carcinoma. Mean utility weights elicited from uninfected subjects had the same relative rankings and similar numerical values. VAS ratings were generally lower than SG utilities and ranked in the same order for infected and uninfected subjects. CONCLUSION: In this, the first study of its kind in Hong Kong, we observed that the health states were associated with substantial loss in health-related quality of life. The lowest utility estimates were associated with decompensated cirrhosis and hepatocellular carcinoma. This information can be used in estimating QALYs for incremental cost-utility analyses.