Consider the following medical report that includes the patient's historical health records. Use it to predict the disease that the patient is high likely exposed to. 

 Medical Report: allergies: patient recorded as having no known allergies to drugs attending: chief complaint: right lower quadrant pain, hypotension major surgical or invasive procedure: embolization of the left hepatic artery. history of present illness: mr. is a 69 year old male with a history of hiv (cd4 238), hepatitis c and multifocal hepatocellular carcinoma with admission in for hemoperitoneum from bleeding cancer focus who presents from home with right lower quadrant abdominal pain which began approximately thirty minutes after he bent down to pick up a crate at the supermarket. the pain continued to worsen and became more diffuse with enlargement of his abdomen. the pain is now severe and . it was associated with nausea, vomiting. it was not associated with diarrhea, constipation, dysuria or hematuria. it was not associated with lightheadedness or dizziness. he presented to the emergency room. . in the emergency room his initial vitals were t: 99.2 hr: 94 bp: 66/36 rr: 16 o2: 100% on ra. he received a total of 4l normal saline and 2 unit prbcs with stabilization of his blood pressure to the 120s systolic. he transiently required levophed but this was quickly turned off. he received vancomycin 1 gram iv and zosyn 4.5 mg iv as well as fentanyl 50 mcg x 1 and dilaudid 1 mg x 1. he underwent a diagnostic paracentesis which showed a calculated hematocrit of 18.5 with 2278 wbcs. he underwent a ct scan with iv contrast which showed a large amount of new perihepatic hemorrhage with evidence for active extravasation at site of previous liver capsular rupture. moderate amount of abdominal pelvic hemorrhage. new segment viii low attenuation concerning for metastasis. increased metstatic disease burden in left lobe. no distant metastasis. he was seen by the surgical consult service who recommended that he undergo emergent ir embolization of bleeding region. . on arrival to the floor his blood pressure is in the 130s sytolic and his heart rate was in the 110s. he continued to note pain in his abdomen. he endorses pain with deep inspiration and mild dyspnea. he denies nausea, vomiting, dysuria, hematuria, lightheadedness, dizziness, melena, hematochezia, leg pain or swelling. all other review of systems negative in detail. . pateint's hct was stable for 24 hours in the unit in 30s. it bumped appropiately after 2 rbc units. antibiotics were stopped. patient has been afebrile. now he is transfered to the omed service to further management of his bleeding and to discuss treatment options. past medical history: past medical history: -hiv on haart - last cd4 238, viral load 334 on -hepatitis c (genotype 1), last viral load 693,000 on -hepatocellular carcinoma with multifocal disease, not a ressection candidate complicated by hemoperitoneum in requiring ir embolization social history: patient is single and rents a room from an elderly woman and acts as her caretaker. was born in bermuda. has 3 daughters and 1 son. smokes 1 pack every 3-4 days for the past 15 years. no etoh in 8 years. prior heavy use in past. no ivdu in 15 years. prior to this used iv heroin and cocaine. family history: diabetes. no known history of malignancy. physical exam: vitals: t: 100.3 hr: 103 bp: 148/95 rr: 18 o2: 98% on 2l . general: awake, alert, speaking in full sentences, wheezes heent: sclera anicteric, mm moist, oropharynx clear, no lymphadenopathy, parotid gland enlargement neck: jvp not elevated cardiac: tachycardic, regular rhythm, s1 + s2, sem rusb , rubs, gallops lungs: expiratory wheezes, no rales or ronchi. pt has ginecomastia. gi: firm, distended, tender diffusely, present bowel sounds, no rebound tenderness, + guarding gu: foley draining red urine, small testes ext: warm and well perfused, 1+ pulses, no clubbing, cyanosis or edema neurologic: no asterixis, grossly intact, a&ox3, cerebelar exam intact, adequate strenght. pertinent results: on admission: 06:40pm wbc-13.5*# rbc-3.47* hgb-10.6* hct-33.1* mcv-96 mch-30.7 mchc-32.1 rdw-18.4* 06:40pm neuts-79.9* lymphs-15.6* monos-3.9 eos-0.3 basos-0.3 06:40pm plt count-436 06:40pm pt-13.2 ptt-26.9 inr(pt)-1.1 06:40pm glucose-238* urea n-13 creat-1.5* sodium-132* potassium-4.2 chloride-98 total co2-20* anion gap-18 06:40pm alt(sgpt)-65* ast(sgot)-55* alk phos-108 tot bili-0.5 06:40pm albumin-3.0* 06:55pm urine color-yellow appear-clear sp -1.019 06:55pm urine blood-neg nitrite-neg protein-tr glucose-neg ketone-tr bilirubin-neg urobilngn-neg ph-7.0 leuk-neg 06:55pm urine rbc-0-2 wbc-* bacteria-few yeast-none epi-0-2 trans epi-0-2 11:57pm lactate-1.6 11:57pm type-art temp-36.6 po2-73* pco2-39 ph-7.34* total co2-22 base xs--4 intubated-not intuba 11:44pm hct-26.8* 11:44pm pt-14.0* ptt-28.4 inr(pt)-1.2* . ekg: sinus tachycardia at 101, left axis deviation, left anterior fascicular block, no acute st segment changes. . imaging: cxr: lung volumes are mildly diminished. no consolidation or edema is noted. the mediastinum is unremarkable. the cardiac silhouette is within normal limits for size. a small hiatal hernia is incidentally noted. no effusion or pneumothorax or free intraperitoneal air identified. the osseous structures are grossly unremarkable. . ct abdomen with contrast: 1. increase in the extent of metastatic disease, likely hepatocellular carcinoma, involving the left lobe of the liver and evidence of capsular rupture and large volume of hemoperitoneum. a new 8 mm hypoattenuating focus within the right lobe of the liver is now seen. an area of increased attenuation within the center of the hemoperitoneum adjacent to the liver is concerning for active extravasation. overall, the amount of hemoperitoneum has increased in size when compared back to the initial presentation of this condition on the ct of . surgical consultation advised. 2. moderate hiatal hernia. 3. left renal cyst. . upon discharge: 05:35am blood wbc-11.8* rbc-3.56* hgb-10.7* hct-32.1* mcv-90 mch-30.1 mchc-33.4 rdw-17.6* plt ct-266 05:35am blood plt ct-266 05:35am blood glucose-79 urean-12 creat-0.6 na-133 k-3.1* cl-101 hco3-25 angap-10 05:35am blood alt-413* ast-141* ld(ldh)-836* alkphos-280* totbili-3.0* dirbili-1.8* indbili-1.2 05:35am blood albumin-2.8* brief hospital course: impression: 69 year old male with history of hiv (cd4 238), hepatitis c and multifocal hepatocellular carcinoma who presents with abdominal pain found to have hemoperitoneum with associated shock likely from bleeding liver malignancy. . hemoperitoneum: patient with evidence of active extravasation of contrast on abdominal ct scan and calculated peritoneal fluid hematocrit of 18. hemodynamically stable s/p 4l normal saline and two units prbcs in ed. he underwent ir embolization of the left hepatic artery. he was monitored 24 hours in the icu with frequent hct that were stable. he did not require further transfusions. his pain was controlled with iv dilaudid and then switched to an oral regimen. . hypotension/hemorrhagic shock: related to acute blood loss in the setting of hemoperitoneum. . acute renal failure: patient's creatinine upon presentation was 1.5 and improved up to 0.6 upon discharge after ivf and stopping hemorrhage. it was thought to be pre-renal renal failure since patient improved rapidly and there were no cast suggesting atn. he had good uop. . hyperglycemia: no documented history of hyperglycemia but blood glucose on chemistry panel is 238. he was started on iss. he had minimal requirements during hospitalization. . hiv: cd4 count 238 with viral load of 334 on . haart was continued. . hepatocellular carcinoma: patient is not good candidate for resection and has already failed hepatic artery embolization in the past. he now bleed into the abdomen and most likely has metastatic disease (not proven). extensive discussions took place between dr. and him and decided to give a 2-week break and then meet to evaluate for either continuing hospice care or oral chemotherapy regimen with sorafenib. . fen: regular diet. . access: 2 16 g peripheral ivs. . prophylaxis: pneumoboots, home ppi. . code: dnr/dni. . contact: proxy name: (sister) phone: . . disposition: home with hospice. medications on admission: senna 8.6 mg :prn combivir 150 mg-300 mg kaletra 200 mg-50 mg 2 tablets methadone 5 mg tid:prn tylenol 325 mg tid:prn omeprazole 20 mg daily ibuprofen 400 mg tid:prn lactulose 30 mls tid:prn for constipation oxycodone 5 mg tab q4:prn discharge medications: 1. nicotine 21 mg/24 hr patch 24 hr sig: one (1) patch 24 hr transdermal daily (daily). 2. lamivudine-zidovudine 150-300 mg tablet sig: one (1) tablet po bid (2 times a day). 3. lopinavir-ritonavir 200-50 mg tablet sig: one (1) tablet po bid (2 times a day). 4. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 5. methadone 5 mg tablet sig: one (1) tablet po tid (3 times a day). 6. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 7. hydromorphone 2 mg tablet sig: one (1) tablet po every six (6) hours as needed for pain: then continue your regular oxycodone, once the pain improves. do not drive or do high risk activities. this medication has sedative effects. disp:*15 tablet(s)* refills:*0* 8. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po once a day as needed for constipation. 9. ibuprofen 400 mg tablet sig: one (1) tablet po three times a day as needed for pain. 10. tylenol 325 mg tablet sig: 1-2 tablets po every six (6) hours as needed for pain. discharge disposition: home with service facility: all care vna of greater discharge diagnosis: primary diagnosis: abdominal hemhorrage secondary to hepatocelular carcinoma. . secondary diagnosis: hepatocellular carcinoma hepatitis c cirrhosis hiv discharge condition: stable, tolerating po, pain controlled, ambulating. discharge instructions: you were seen at the for abdominal pain. you had a ct scan of your abdomen that showed signs of bleeding. some fluid from your abdomen was obtained and it showed blood corroborating the prior clinical impression. you bleed from your liver massess, therefore you underwent ebolization of one of the arteries of your liver to stop the bleeding. you required multiple blood transfusions to replete the loss. we followed closely your blood level and it was stable and you did not further require any transfusions. you had exacerbation of your abdominal pain that was controlled with dilaudid. you will meet with dr. and dr. (see below) to discuss further oral chemotherapy and other ways we can help you. . if you have chest pain, shortness of , changes in the abdominal pain, stools, blood in your stools, or anything else that concerns you please come back to our er. . we started you on a nicotine patch. you can use if if you want to stop smoking. do not use the patch and smoke at the same time. followup instructions: provider: , md phone: date/time: 10:00 provider: , md phone: date/time: 10:00 . please follow with oyour pcp within month of discharge. procedure: percutaneous abdominal drainage other endovascular procedures on other vessels diagnoses: tobacco use disorder cirrhosis of liver without mention of alcohol acute posthemorrhagic anemia acute kidney failure, unspecified unspecified viral hepatitis c without hepatic coma other shock without mention of trauma malignant neoplasm of liver, primary asymptomatic human immunodeficiency virus [hiv] infection status hemoperitoneum (nontraumatic) other abnormal glucose 

Answer: The patient is high likely exposed to