Abstract: Objective To investigate the relationship between immune inflammatory markers and the prognosis of patients with acute-on-chronic liver failure associated with hepatitis B viral infection (HBV-ACLF). Methods A total of 98 HBV-ACLF patients with complete clinical data admitted to the Second People’s Hospital of Lanzhou from January 2020 to December 2022 were collected. The patients were divided into an improvement group (N=65 cases) and a death group(N=33 cases)based on their clinical outcomes. The differences in age, gender, blood cell count, infection indicators, systemic immune inflammation index (SII), and Model for End-Stage Liver Disease (MELD) scores were analyzed among the two groups of patients. Correlation analysis was conducted between blood cell count, infection indicators, SII, and MELD scores of the two groups of patients. Results In the improvement group,platelet count (PLT), interleukin-6 (IL-6), and MELD scores are 122.2±50.5,17.9 (8.6, 23.1), and 8.8±5.2, respectively, which were significantly different with those of 91.7±38.1,16.1 (11.5, 43.3), and 21.9±4.8 in the death group (t=2.186, P=0.034; Z=0.748, P=0.045; t=2.048, P=0.046). The correlation analysis between blood cell count, infection indicators, SII and MELD score showed that white blood cell count (WBC), neutrophil count (NEU), procalcitonin (PCT) were positively correlated with MELD score (r=0.312, P=0.027; r=0.419, P=0.002; r_s=0.507, P<0.001), PLT was negatively correlated with MELD score (r=-0.350, P=0.013), and other indicators were not correlated with MELD score (P>0.05). Conclusion Elevated levels of WBC, NEU, PCT, and decreased levels of PLT are associated with short-term prognosis in HBV-ACLF patients upon admission.

Key words: Immunoinflammatory markers, acute-on-chronic liver failure associated with HBV infection, Prognosis, Correlation