An array of non-communicable diseases as well as chronic infections related to ongoing economic and lifestyle swings on the one hand, and a legacy of "traditional" communicable diseases on the other, characterize the emerging disease burden scenario of the developing and transitional economies of the world [1]. India is in the middle of huge socioeconomic and demographic swings, and the pattern of its health care challenges is also changing [2]. The liver, as an organ, presents the perfect interface for this disease burden "spectral drift". The infection-lifestyle interplay in etiology, disease biology and outcome are all too evident in the case of chronic liver diseases -hepatitis C virus (HCV) representing the "infection port", while alcoholism and metabolic syndrome (MS) related nonalcoholic fatty liver disease (NAFLD) highlight the contribution of "lifestyle" in this evolving pattern [3]. Public health planning, prioritization and allocation of resources in India need to be cognizant of all these features of liver disease burden to be futuristic and useful. While disease burden includes a range of biological (etiologies), clinical outcome (morbidity, mortality), system stressors (health care utilization) and economic factors that are relevant in planning preventive strategies, the most simple, objective and useful measure of burden is an estimate of prevalence of an etiological agent like HCV and HBV in the population [4,5].In chronic infections like that caused by HCV, prevalence studies are important epidemiological "eye openers" as they bring into focus the magnitude of the current health care burden due to it [6,7]. Over and above, they provide the frame for downstream descriptive and analytical studies as well as provision of well phenotyped cohorts of infected individuals for precise delineation of the natural history of infection and disease at a later time point. Widespread geographical and ethnic differences in the prevalence of HCV are well known globally [8]. Such variations in prevalence provide insight into the risk factors and mode of transmission of the virus in the population in context and can guide targeted interventions. Thus in Egypt, the country with highest HCV prevalence globally, elegant epidemiological studies demonstrating a close association between a nationwide campaign against schistosomiasis by parenteral injections of tartar emetic by health workers and prevalence of HCV in the general population led to a country wide campaign against injection abuse [9,10]. India, with its rich population diversity, has tremendous loco-regional differences in prevalence of HCV as well as of HBV [11,12]. Thus, while isolated ethnic groups have been demonstrated to have very high HCV and HBV prevalence, the overall reported HCV prevalence in the population has been around 1 %.Sood et al. in a population based survey from Punjab, now report a very high (5.2 %) seroprevalence of HCV infection, with highest prevalence in the 40-60 years age group and a significant clustering of infection within fam...