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Keywords: Hepatitis B virus; Acute-on-chronic liver failure; Prognosis EN Hepatitis B virus Acute-on-chronic liver failure Prognosis 479 480 2 12/30/20 20210201 NES 210201 To the Editor: We read the paper "The PREDICT study uncovers three clinical courses in acutely decompensated cirrhosis with distinct pathophysiology" published in Journal of Hepatology with great interest.[1] This multicenter study reported on 3 different clinical courses with distinct pathophysiology and prognosis in patients with acute decompensation (AD) of cirrhosis. Clinical and laboratory characteristics of the pre-ACLF patients (n = 90), ACLF patients at the time of admission (n = 189) and patients with AD without ACLF development (n = 587) were compared in Table 1. The prevalence of HBV reactivation was different (p <0.001) among these patients and higher in pre-ACLF patients (56.7%) and ACLF patients (57.7%). [Extracted from the article]