Moreover, several recently published studies have demonstrated that overwhelming bystander activation of CD8+ T cells can lead to an inflammatory state and contribute to a fulminant course of acute infection,15 as well as directly drive liver damage through an innate-like hepatotoxic killing activity.[12], [13], [14],42 Interestingly, we observed higher frequencies of ascites CXCR6+CD69+ CD8+ T cells in patients with ACLF in the absence of ongoing infection. Here, CD8A is linked to infection.