This study constitutes a bidirectional cohort investigation. By collating laboratory parameters and clinical data-including plasma and peripheral blood mononuclear cell (PBMC) analyses-from patients with acute-on-chronic liver failure, it aims to provide a reference framework for predicting prognosis and the occurrence of complications.

Inclusion Criteria:

•Clinical diagnosis of Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF)

Exclusion Criteria:

• age < 18 years
• extrahepatic organ failure unrelated to ACLF
• active malignancy
• co-infection with other hepatitis viruses or human immunodeficiency virus (HIV)
• prior liver transplantation
• use of immunosuppressants within 6 months before enrollment
• unclear history of antiviral therapy

Hospitalized patients diagnosed with Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) .