Shalimar DM, et al. – Physicians designed this study to assess the outcomes of acute–on–chronic liver failure (ACLF) with different acute insults. Compared with hepatitis E virus (HEV)/hepatitis B virus (HBV)–ACLF, alcohol/cryptogenic–ACLF had a more severe phenotypic presentation, more incidence of organ failures, and higher mortality. While HEV–ACLF had the best survival, alcohol–ACLF had the highest mortality.