OBJECTIVES: Limited country-specific data exist on health-related quality-of-life (HRQoL) impacts of hepatitis C virus (HCV) infection. The aim of this study was to elicit preference values for HCV-specific health states from general public participants in Australia, Brazil, France, Italy, and Spain. METHODS: HCV health state descriptions were based on literature review and clinical expert feedback for the following: asymptomatic and symptomatic mild/moderate HCV, compensated cirrhosis, five decompensated cirrhosis states (hepatocellular carcinoma, ascites, acute and chronic variceal hemorrhage, and hepatic encephalopathy), and liver transplant (first year and subsequent years).  These descriptions included key HRQoL impacts (activities, mood, stigma, cognition, and sleep) associated with each state, and were validated by members of the general public. Trained interviewers elicited time trade-off preference values (or, utilities) from a general public sample, quantifying preferences for each health state on a scale of 0 (dead) to 1 (full health). Mean (95% confidence interval) preferences were estimated for each country and adjusted for age and sex using beta and generalized linear models. RESULTS: Logical responses from 488 participants were included; approximately 50% were male. Mean ages ranged from 39.1 (Brazil) to 47.7 (Italy) years. Mean values for asymptomatic mild/moderate HCV health states ranged from 0.90 (0.88-0.91; Australia) to 0.79 (0.76-0.81; Brazil); for the acute variceal hemorrhage health state, mean values were 0.27 (0.24-0.29; France) to 0.39 (0.39-0.42; Italy).  Mean preferences for compensated cirrhosis ranged from 0.69 (0.33-0.72; Brazil) to 0.77 (0.75-0.79; Australia).  Values were less than 0.70 for all decompensated cirrhosis states. Age- and sex-adjusted beta and generalized linear models showed similar results. CONCLUSIONS: This study provides estimates of the quality of life decrement associated with severe liver disease health states, from the general public perspective. This information is important for understanding the benefit of early treatment to delay disease progression in patients with HCV.