As confirmed by the PREDICT (PREDICTing Acute-on-Chronic Liver Failure) study, another large-scale European prospective investigation designed to identify predictors of this syndrome, patients with ACLF were younger, showed higher levels of white blood cells and C-reactive protein (CRP) and had a greater prevalence of bacterial infections, severe alcoholic hepatitis, variceal bleeding, drug-induced encephalopathy as precipitants, with respect to patients without ACLF [2,12,13]. This evidence concerns the gene CRP and bacterial infectious disease.