Our results showed that genotype B infection was more frequently observed in HB-ACLF than in patients with CHB, suggesting that patients with CHB infected with genotype B have a higher risk of developing liver failure than those infected with genotype C. A significantly higher occurrence of BCP mutations at the 1753, 1762 and 1764 sites, and PC mutations at the 1896 and 1899 sites were found in patients with HB-ACLF than in patients with CHB (Table 1), suggesting that accumulation of BCP/PC mutations could be a potential indicator and probably a contributor to HB-ACLF development. Here, OPN1SW is linked to infection.