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The cost-effectiveness of antiviral treatment in adult immune-tolerant (IT) phase chronic hepatitis B (CH patients is uncertain. We designed a Markov model to compare expected costs and quality-adjusted life-years (QALYs) of starting antiviral treatment at IT-phase ('treat-IT' vs delaying the therapy until active hepatitis phase ('untreat-IT' in CHB patients over a 20-year horizon. A cohort of 10 000 non-cirrhotic 35-year-old patients in IT-phase CHB (hepatitis B e antigen-positive, mean serum hepatitis B virus (HBV) DNA levels 7.6 lo