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: abacavir / vancomycin / haldol / heparin agents / bactrim ds / actonel attending: chief complaint: gi bleed major surgical or invasive procedure: endoscopy history of present illness: hpi: 51 female with pmh significant for hiv, hcv cirrhosis s/p orthotopic transplant in c/ tear and varices, pancytopenia, transferred from micu after presenting with one day of brbpr and hematemesis on . she stated that she had several large bowel movements one day prior to admission with brbpr and large clots. later that evening she had 4 episodes of vomiting blood. the following day she was very weak, felt palpitations and was admitted to the hospital. ed course: hct was 13 with prior hct recorded as 24.7. urgent endoscopy revealed no source of bleeding. she was given 80mg iv protonix and 80mg oxycontin. she had a femoral cortis placed. her blood was sent for type and crossmatch. she was admitted to micu. past medical history: # hiv, last cd 4 count 51 and vl <50 in # hcv s/p liver xplant 2/. transplant complicated by a anhepatic period x 24 hours due to edematous primary transplant necessitating second liver, also complicated by pe with placement of ivc filter. recent liver biopsy showed rurrent hcv and stage 2 fibrosis - currently being monitored. last vl 1.46 mill -followed by dr. and dr. # pancytopenia: w/u wih dr. (see note), bm biopsy consistnet with hiv related anemia. # chronic methadone use: recently stopped, now on oxycontin # depression - on celexa # fibromyalgia/chronic pain # cri (baseline creat 1.3-1.9) # anemia: baseline 28-30, bm bx thought c/w hiv related anemia social history: lives alone in . has boyfriend involved in care. works in family restaurant. substance abuse counsellor. divorced. former iv heroine, cocaine user. tobb: 1ppd etoh none lives alone in . boyfriend stays over. works in family restaurant. substance abuse counsellor. divorced. former iv heroine, cocaine user. tobb: 1ppd etoh none family history: mom: ra, breast ca, ami dad: mi : ivdu sister: asthma ca: uncle physical exam: tmax 98.9 tc98.5 bp 108-123/57-67 hr 74 (70-80) rr 20 o2 95%ra i/o 120/620 (today) +2145 (net los) gen- awake, alert, appropriate female in nad heent- perrl, eomi, anicteric neck- supple, no lad, jvp flat cor- rrr, no m/r/g chest- ctabl abd- soft, nt, nd no g/r. positive bowel sounds. y-shaped scar- well healed ext- no c/c/e neuro- aao x 3; cn ii-xii intact. no focal findings. skin- multiple spider angioma on skin. pertinent results: 04:30pm plt count-81* 04:30pm neuts-59.1 lymphs-30.7 monos-7.9 eos-2.1 basos-0.2 04:30pm wbc-2.5* rbc-1.27*# hgb-4.3*# hct-13.2*# mcv-104* mch-33.9* mchc-32.7 rdw-18.4* 04:30pm albumin-3.1* calcium-8.1* phosphate-3.0 magnesium-2.2 04:30pm lipase-61* 04:30pm alt(sgpt)-14 ast(sgot)-25 alk phos-63 amylase-41 tot bili-1.1 04:30pm estgfr-using this 04:30pm glucose-107* urea n-42* creat-1.7* sodium-139 potassium-3.8 chloride-106 total co2-26 anion gap-11 04:39pm hgb-4.4* calchct-13 06:05pm pt-13.8* ptt-37.1* inr(pt)-1.2* 07:41pm fk506-4.8* 11:19pm hct-22.5*# ct chest : 1. new small amount of intra-abdominal ascites. 2. 6 mm peripheral right upper lobe nodule, which may have mildly increased in size. diagnostic considerations again include infectious or neoplastic entities. short interval follow-up is recommended. 3. scattered centrilobular ground-glass opacities with upper lobe predominance, which in a , represent respiratory bronchiolitis. . echo : conclusion- the left atrium is normal in size. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef >55%) right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. trivial mitral regurgitation is seen. there is mild pulmonary artery systolic hypertension. there is a trivial/physiologic pericardial effusion. impression: normal global and regional biventricular systolic function. mild aortic regurgitation. mild pulmonary hypetension. . liver u/s : 1. increased moderate amount of ascites. 2. elevated resistive index in the right hepatic artery of uncertain significance. clinical correlation and short-term followup is recommended. 3. splenomegaly. brief hospital course: assessment and plan: 51 yo w with h/o hiv, hcv cirrhosis s/p orthotopic transplant , presented with acute gi bleed. . # gi bleed: patient was admitted to the micu for acute drop in hct associated with hematemesis. egd on night of admission showed grade i varices with no active bleed, normal stomach and duodenum. it is felt that her bleeding was variceal in nature given hematemesis, and patient had recent colonoscopy that did not demonstrate any potential sources of bleeding. repeat egd demonstrated esophageal varices as well as gastropathy. banding was not done as that would likely make gastric varices worse. if patient were to re-bleed, there is no further endoscopic intervention and she would require urgent tips. hct trend from 27.8, 28.4, to 26.1. patient's hct trended down slowly and was noted to have guaiac positive stool, but no acute drop occurred and patient had no further episodes of bright red blood, melena or dark stools. patient was therefore maintained on ppi and nadolol. patient was treated with ceftriaxone x 5 days for prophylaxis in setting of gi bleed. . # hiv: she has chronically low cd4 counts and has had difficulty with different regimens due to anti-rejection meds. patient was continue on home regimen of antiretrovirals and dapsone and azithromcyin for mac/pcp . . # cirrhosis / transplant: her last biopsy did show a progression to stage 3 fibrosis in her transplanted liver. patient also with portal hypertension, ascites and variceal bleed demonstrating worsening of her liver disease. patient's tacrolimus level was monitored with a goal fo and was dosed weekly. . # prior pulmonary nodules seen on imaging: ct chest revealed 6mm peripheral rul nodule with mild increase in size, ? infectious vs neoplastic. recommend short interval follow up ct. also some ground glass opacities centrilobular, likely bronchiolitis in . patient was directed to follow up findings on ct in a few months. . # pancytopenia: patient is pancytopenic at her baseline. prior workup was unrevealing but pointed toward effect of hiv or antiretrovirals. . # depression: mood seems appropriate. patient states she was thinking of becoming nursing assistant and will now likely need to change her plans due to progression of fibrosis of her liver transplant. she was continued on home dose celexa. . # fibromyalgia: she takes oxycontin 40mg at home for pain. this was continued in house. . # arf: patient was noted to have impaired creatinine clearance with serum creatinine elevated to 1.7. her baseline creatinine is 1.1-1.4, and her creatinine and bun returned to baseline during her course. her arf was felt to be secondary to to dehydration and hypovolemia due to bleeding and poor po intake. she had good urine output and creatinine clearance improved with fluids. at time of discharge, patient was again started on lasix and aldactone without difficulty. . # hit positive in past: all heparin products were held. medications on admission: - azithromycin 600 q thursday - citalopram 60 qd - dapsone 100 qd - marinol 10 - truvada 200-300 qd - epo 40,000 units qweek - lasix 20 qd - ativan 1mg prn - nelfinavir 1250 - oxycontin 40 - oxycodone 5 prn - phenergan 25 prn - prograf 0.5 twice weekly discharge medications: 1. azithromycin 600 mg tablet sig: one (1) tablet po 1x/week (th). 2. citalopram 20 mg tablet sig: three (3) tablet po daily (daily). 3. dapsone 100 mg tablet sig: one (1) tablet po daily (daily). 4. emtricitabine-tenofovir 200-300 mg tablet sig: one (1) tablet po daily (daily). 5. epoetin alfa 10,000 unit/ml solution sig: one (1) injection qmowefr (monday -wednesday-friday). disp:*20 * refills:*2* 6. nelfinavir 625 mg tablet sig: two (2) tablet po bid (2 times a day). 7. nadolol 20 mg tablet sig: one (1) tablet po daily (daily). 8. ciprofloxacin 250 mg tablet sig: one (1) tablet po q24h (every 24 hours). disp:*30 tablet(s)* refills:*6* 9. furosemide 20 mg tablet sig: one (1) tablet po daily (daily). 10. oxycodone 20 mg tablet sustained release 12 hr sig: tablet sustained release 12 hrs po q12h (every 12 hours). 11. prograf 0.5 mg capsule sig: one (1) capsule po twice a week. 12. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours): take medication 12 hours apart from truvada. disp:*30 tablet, delayed release (e.c.)(s)* refills:*6* discharge disposition: home discharge diagnosis: primary: variceal bleed, hepatitis c, cirrhosis s/p transplant, acute renal failure secondary: hiv, pulmonary nodule discharge condition: good with stable hematocrit discharge instructions: you were admitted to the hospital because of a variceal bleed. you were given 4 units of blood. your hematocrit ( marker of blood level) has been stable. . you are due for a dose of boniva on . please contact your primary care physician to obtain this dose. . you have been started on a new medication called ciprofloxacin. this is to prevent an infection in your abdomen (belly). you were also started on pantoprazole to decrease acid in your stomach. please take this dose 12 hours apart from the truvada. . please take all your medications as prescribed. do not make any changes to your medication without consulting your physician. . if you develop any worrisome symptoms such as vomiting blood or blood in your stool, chest pain, shortness of breath, please return to the emergency room. . please call dr. to make a follow up appointment in weeks. . followup instructions: please follow up with dr. by calling ( in weeks. procedure: venous catheterization, not elsewhere classified other endoscopy of small intestine other endoscopy of small intestine diagnoses: tobacco use disorder acute kidney failure, unspecified portal hypertension other chronic pulmonary heart diseases depressive disorder, not elsewhere classified human immunodeficiency virus [hiv] disease chronic kidney disease, unspecified long-term (current) use of other medications other diseases of lung, not elsewhere classified personal history of venous thrombosis and embolism other ascites esophageal varices in diseases classified elsewhere, with bleeding dehydration hypovolemia complications of transplanted liver surgical operation with transplant of whole organ causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation myalgia and myositis, unspecified 

Answer: The patient is high likely exposed to