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Aim: Hepatocyte apoptosis induced by tumor necrosis factor(TNF)-α/TNFR1 is an important pathway for the incidence of fulminant viral hepatitis.Accumulating evidence suggests that a limited number of microRNAs(miRNAs)are involved in severe exacerbation of hepatitis B.The relationship between circulating miRNAs and HBV associated acute-on-chronic liver failure(HBV-ACLF)need to be further investigated.