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: bactrim / flexeril attending: chief complaint: confusion major surgical or invasive procedure: liver transplant ercp with stent placement history of present illness: mr. is a 46 yo man with hiv (cd4 535; vl <50), hcv cirrhosis s/p recent hospitalization at for confusion which was thought to be secondary to prerenal azotemia secondary to several large volume taps. at home his confusion continued and he returned to medical care, this time at er, for this continued complaint. he has reportedly been having bms/day on lactulose and had been continuing to take his rifaximin for hepatic encephalopathy as well as norfloxacin for sbp ppx. in the ed, he was found to be trace guaiac positive and to have a mildly decreased hct. his ammonia was 128 but according to his wife this was down from 220 at . his cr was 2.7 (up form 1.7) but according to his wife he had been 2.8 at . past medical history: - hcv x 13y- last vl 637,000 genotype i, s/p pegasys treatment; h/o diuretic resistent ascites and hepatic encephalopathy x 2 episodes - hiv x 16y: cd4 535 on ; vl <50 on - cri with baseline cr 1.7 - s/p ccy - s/p herniorrhaphy - s/p repair of nasal septum deviation social history: lives with common law wife of 13 years, . has been clean and sober x 17 years, past use of alcohol, cocaine, heroin and "everything." smokes 1/2ppd tobacco. in past was in prison for 1.5 years for illicit drug sales family history: mother - pancreatic cancer, father - bladder cancer, stroke and diabetes. brother - prostate cancer physical exam: 96.8, 117/67, 82, 95% ra, wt 105kg gen; somnolent and minimally arousable, does not follow commands heent: ncat, psoriasis ofver scalp, scleral icterus, perrl neck: no lad; cannot assess jvp cor: holosystolic murmur at lusb, nonradiating, rrr, nl s1 s2 pulm: diffuse wheezes b abd: tense ascites, no bs, nt, cannot assess organomegally ext: 3+ pitteing edema b neuro: somnolent skin: many tatoos; psoriatic plaques, stage 1-2 decub over buttocks . on discharge gen: alert and oriented, carries on appropriate conversations lungs: clear abdomen; soft, nt, minimally distended, no fluid wave, jp securely in place with serosanguinous fluid, large midepigastric incision scar c/d/i and healing with staples in place, +bs ext: edema improved pertinent results: labs: see below: ammonia 128 (per pt's wife was 220 at few days ago); lfts below baseline; bun 84/cr 2.7; inr 1.7; platelets 89; hct 27.5. . studies: ruq u/s: preliminary report- a large amount of ascites is seen. a spot for paracentesis was marked in the right mid abdomen. . cxr: clear . abd mri pending read . ucx + enterococcus, pan (macrobid, amp) ua + few bacteria, wbc, otherwise clear . peritoneal fluid: no growth, <30% pmns, alb<1, gram stain negative . admit cr 2.7, nadir cr 1.7 (baseline 1.5), discharge cr admit tbili 3.4, peak tbili 6.1, discharge bili inr . echo: 1. the left atrium is mildly dilated. 2. left ventricular wall thickness, cavity size, and systolic function are normal (lvef>55%). regional left ventricular wall motion is normal. 3. the aortic valve leaflets (3) are mildly thickened. 4. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. . colonoscopy: normal to cecum egd: no varices were noticed. granularity, friability, erythema, congestion and abnormal vascularity in the whole stomach compatible with portal gastropatrhy. otherwise normal egd to second part of the duodenum 05:15am blood wbc-5.2 rbc-3.80* hgb-11.7* hct-34.9* mcv-92 mch-30.8 mchc-33.5 rdw-18.1* plt ct-74* 05:44am blood wbc-4.8 rbc-3.56* hgb-11.3* hct-32.5* mcv-91 mch-31.7 mchc-34.8 rdw-17.9* plt ct-61* 05:15am blood plt ct-74* 11:54am blood fibrino-215 05:15am blood glucose-171* urean-46* creat-1.8* na-140 k-3.9 cl-115* hco3-17* angap-12 05:15am blood alt-109* ast-44* alkphos-166* totbili-2.4* 05:44am blood alt-111* ast-50* alkphos-200* totbili-5.5* u/s: hepatic arterial flow is now more normal in appearance compared to the prior study but the portal velocities have increased across the anastomosis from 60-160 cm/sec. clinical consideration should be given to the possibility of significant portal stenosis and correlation with the clinical and biopsy findings is recommended. cta: no evidence of stenosis, large amount of ascites, 10 x 4 cm infrahepatic hematoma. ercp: evidence of extravasation of contrast from the cystic stump, consistent with biliary leak. status post plastic cbd stent placement. filling defects within the biliary system could be consistent with air, but other causes cannot be entirely excluded. brief hospital course: 46 yo man with hiv (cd4 535; vl <50), hcv cirrhosis was being evaluated for liver transplant and diuretic resistent ascites who presented with confusion. he was obtunded/encephalopathic, most likely hepatic encephalopaty + effect of ambien in patient with poor hepatic fx. he was admitted and had a basic infectious workup including diagnostic paracentesis, blood, and urine cx which were all negative for infection. ambien/other sedating meds were held and he was begun on for goal bm /day + rifaxamib. his meld score on admission was 32 and he was listed for liver transplant. the patient received a liver transplant on . postoperatively he was taken to the sicu, where on pod 1 his drain output increased and he began to drop his hematocrit. he was taken to the operating room for washout and control of bleeding. postoperatively he was taken back to the sicu in stable condition. on pod , liver u/s showed patent right, left, and main hepatic arteries, however without diastolic flow, and a subhepatic hematoma measuring 8 x 4 x 8 cm. he was extubated on the morning of pod and transfered to the regular floor in the pm in stable condition. on pod , there was an elevation in his tbili and alk phos and a transjugular liver biopsy was obtained, and was indeterminate for acute cellular rejection. an ultrasound showed good arterial flow but a questionable portal stenosis. a cta was obtained, showing patent hepatic and portal flow, with a large amount of ascites and a 10 x 4 cm infrahepatic hematoma. jp drain tbili checked the following day was 21.9. he underwent ercp on pod , and a biliary stent was placed after contrast was noted to drain from the cystic duct stump. his jp drainage cleared, and on pod , his drain bilirubin was measured at 0.8. his drain output decreased. on pod 17/16, his drain was taken off of bulb suction, and on pod 18/17, his drain was removed and the site sutured with 3-0 nylon suture. he was discharged to home on pod19/18 with follow-up with dr. . medications on admission: furosemide 120 mg per day, aldactone 300 mg per day, epivir 300 mg per day, lactulose 45 cc per day, rifaximin 400 mg three times a day, tenofovir 300 mg per day, quinine sulfate 260 mg as needed, sustiva 600 mg per day, ambien cr 6.25 mg po once daily, prilosec 40 mg per day, albuterol inhaler 1-2 puffs q4-6h, dovonex cream, and (----------?dosevan) as needed. discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 2. mycophenolate mofetil 500 mg tablet sig: two (2) tablet po bid (2 times a day). 3. efavirenz 600 mg tablet sig: one (1) tablet po daily (daily). 4. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 5. fluconazole 200 mg tablet sig: two (2) tablet po q24h (every 24 hours). 6. valganciclovir 450 mg tablet sig: one (1) tablet po daily (daily). 7. lamivudine 150 mg tablet sig: two (2) tablet po daily (daily). 8. tenofovir disoproxil fumarate 300 mg tablet sig: one (1) tablet po daily (daily). 9. prednisone 5 mg tablet sig: 3.5 tablets po once a day for 6 days: continue until , then drop to 3 tablets (15 mg) continue taper as directed by transplant clinic. 10. lamivudine 150 mg tablet sig: one (1) tablet po daily (daily). 11. tenofovir disoproxil fumarate 300 mg tablet sig: one (1) tablet po 2x/week (mo,th). 12. valganciclovir 450 mg tablet sig: one (1) tablet po every other day (every other day). 13. insulin syringe syringe sig: one (1) syringe miscellaneous for insulin. disp:*1 box* refills:*3* 14. tacrolimus 1 mg capsule sig: three (3) capsule po bid (2 times a day). disp:*180 capsule(s)* refills:*2* 15. tacrolimus 0.5 mg capsule sig: one (1) capsule po twice a day: take three 1mg capsules and one 0.5 mg capsule together (for a total dose of 3.5 mg) twice a day. disp:*60 capsule(s)* refills:*2* 16. oxycodone 5 mg tablet sig: 1-2 tablets po every 4-6 hours as needed for pain. disp:*30 tablet(s)* refills:*0* 17. insulin glargine 100 unit/ml solution sig: nine (9) units subcutaneous at bedtime. disp:*1 bottle* refills:*2* 18. insulin lispro (human) 100 unit/ml solution sig: per sliding scale subcutaneous per sliding scale. disp:*1 bottle* refills:*2* discharge disposition: home with service facility: discharge diagnosis: primary diagnosis: esld awaiting transplantation. - hcv x 13y- last vl 637,000 genotype i, s/p pegasys treatment; currently being evaluated for possible liver transplant candidacy; h/o diuretic resistent ascites and hepatic encephalopathy x 2 episodes - hiv x 16y: cd4 535 on ; vl <50 on - s/p liver transplant discharge condition: good discharge instructions: call transplant office if fevers, chills, nausea, vomiting, inability to take medications, abdominal pain, jaundice, increased drainage from drain, bleeding/redness/pus at drain site or from incision, lightheadedness. labs every monday & thursday for cbc, chem 10, ast, alt, alk phos, tbili, albumin and trough prograf level. please do not drive while taking narcotic pain medications. please take all medications as prescribed. please follow up as directed. follow up hiv viral load at clinic visit take 3.5 mg of prograf twice a day, unless instructed otherwise followup instructions: please follow-up as directed. provider: , md phone: date/time: 8:10 provider: , transplant social work date/time: 10:00 provider: , md phone: date/time: 8:20 md, procedure: other endoscopy of small intestine other endoscopy of small intestine closed (percutaneous) [needle] biopsy of liver percutaneous abdominal drainage percutaneous abdominal drainage percutaneous abdominal drainage percutaneous abdominal drainage endoscopic sphincterotomy and papillotomy control of hemorrhage, not otherwise specified colonoscopy endoscopic insertion of stent (tube) into bile duct other transplant of liver transfusion of packed cells transfusion of other serum other operations on lacrimal gland transplant from cadaver diagnoses: urinary tract infection, site not specified cirrhosis of liver without mention of alcohol diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute and subacute necrosis of liver chronic hepatitis c with hepatic coma acute kidney failure, unspecified hepatorenal syndrome acquired coagulation factor deficiency hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified asthma, unspecified type, unspecified hemorrhage complicating a procedure long-term (current) use of insulin blood in stool pressure ulcer, lower back other psoriasis unspecified gastritis and gastroduodenitis, without mention of hemorrhage asymptomatic human immunodeficiency virus [hiv] infection status edema of male genital organs combinations of opioid type drug with any other drug dependence, in remission 

Answer: The patient is high likely exposed to