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: ampicillin attending: chief complaint: low hematocrit major surgical or invasive procedure: none history of present illness: 58 yo f with hiv on haart, (cd4+:266 and vl undetectable ), hcv cirrhosis w/o known varices, esrd on hd ( hiv nephropathy) p/w a hb of 7 found in hd today. of note, patient was recently admitted to the medicine service from - for melana. push enteroscopy performed on did not show any active bleeding but was significant for gastritis. she did not require any blood transfusions and since she remained hds was discharged home with close followup. since discharge she continued to have melontic stools x 5 days with associated lightheadedness and fatigue that has been constant. since 5 days ago hct: 36.5 ()--> 33 () --> 23.2 today. in hd today, 2.7 kg of fluid was taken off. . of note, she was also admitted with melana, and underwent a capsule study which showed active bleeding in her duodenum. egd at that time revealed no active bleeding, portal htn-ive gastropathy, no esophageal varices noted. a colonoscopy also performed showed two sessile adenomatous polyps though examination of mucosa limited by melena which were removed. an enteroscopy had been attempted at this time but was deferred since the patient had eaten. she remained without evidence of melana until this most recent admission . . in ed vs were 97.5 95 113/68 16 97% ra. (baseline sbp in the 110s-120s noted in omr) received 1 liter ns. did not receive prbcs. ng lavage pink in first 150 cc and did not clear with another 300 cc -> pink with specs of blood. given 40 iv pantoprazole. gi consulted and suggested a tagged rbc scan to find active bleeding. notably, guaiac positive brown stool. vitals prior to transfer bp: 109/61 87 100% 2l . upon arrival to the micu, patient was hds and felt mildly fatigued. c/o mild abdominal pain. blood transfusion was started prior to transfer to nuclear medicine for tagged rbc. past medical history: 1. esrd due to hiv nephropathy, on hemodialysis (tuthusat), right transposed basilic av fistula 2. hiv, diagnosed ; last cd4 143 vl 49 () 3. hepatitis c with reported cirrhosis and portal hypertension; diagnosed mid- per pt; not treated with interferon, followed and monitored by liver center 4. zoster 5. bronchitis (recently diagnosed, pt has not started treatment social history: patient on disability. lives alone, but has 5 adult children. >25 pack-year tobacco history, currently smokes ppd. history of crack cocaine use and ivdu (per pt, last use 10 yrs ago); stopped since starting dialysis ~. denies etoh use. family aware of hiv diagnosis. family history: mother with dm, htn; died from brain aneurysm. gm with dm, htn; died from diabetic coma. older sister died of liver cancer. sister w/ breast cancer. physical exam: vs: 84 127/68 18 100% 2l ga: aox3, nad heent: perrla. mmm. no lad. no jvd. neck supple. cards: pmi palpable at 5/6th ic space. no rvh. rrr s1/s2 heard. 2-3/6 sem heard best at base pulm: diffuse crackles and rhonchi heard bilaterally. moving air abd: soft, ttp in ruq and rlq, +bs. no g/rt. neg hsm. extremities: wwp, no edema. dps, pts 2+. 16g and 18g in left arm. fistula with palpable thrill in right arm. skin: no rashes neuro/psych: cns ii-xii intact. 5/5 strength in u/l extremities. sensation intact to lt, gait deferred. pertinent results: admission labs: 07:20pm blood wbc-3.9* rbc-2.50*# hgb-7.4* hct-23.2*# mcv-93 mch-29.8 mchc-32.1 rdw-17.6* plt ct-83* 07:20pm blood neuts-63.5 lymphs-26.3 monos-5.3 eos-4.3* baso-0.5 07:55pm blood pt-15.7* ptt-27.6 inr(pt)-1.4* 07:20pm blood glucose-89 urean-27* creat-4.6* na-140 k-3.6 cl-98 hco3-33* angap-13 07:20pm blood alt-9 ast-15 alkphos-50 totbili-0.3 07:20pm blood lipase-73* 02:02am blood calcium-7.9* phos-4.6* mg-1.6 06:15am blood %hba1c-5.6 eag-114 . pertinent labs 06:14am blood hct-27.9* 04:39pm blood hct-27.8* 08:10am blood wbc-4.7 rbc-3.00* hgb-9.0* hct-27.7* mcv-92 mch-29.9 mchc-32.4 rdw-17.6* plt ct-82* 08:00am blood wbc-5.0 rbc-3.23* hgb-9.6* hct-30.6* mcv-95 mch-29.6 mchc-31.3 rdw-17.7* plt ct-87* microbiology: none imaging: tagged rbc scan: following intravenous injection of autologous red blood cells labeled with tc-m, blood flow and dynamic images of the abdomen for 60 minutes were obtained. blood flow images show normal vascular tracer distribution. dynamic blood pool images show no evidence of tracer within the gastrointestinal tract. impression: no evidence of gi bleeding. admission cxr: mild central vascular congestion without overt edema. stable cardiomegaly. small bowel enteroscopy: impression: erythema in the whole stomach compatible with gastritis otherwise normal small bowel enteroscopy to jejunum colonoscopy: polyp in the transverse colon (polypectomy, endoclip), polyp in the sigmoid colon (polypectomy) grade 1 internal hemorrhoids there was melanotic blood coating along th ecolon mucosa. we were unable to thoroughly examine the mucosa of colon. otherwise normal colonoscopy to cecum egd: : hiatal hernia noted. erythema, congestion, petechiae and abnormal vascularity in the whole stomach compatible with portal hypertensive gastropathy. otherwise normal egd to third part of the duodenum. no esophageal or gastric varices noted. no source of bleeding visualized on examination to the 3rd portion of the duodenum. recommend continue ppi. would recommend enteroscopy for further evaluation. capsule study: summary: 1. the capsule remained in the stomach for 3h 2. active bleeding in the duodenum 3. fresh blood in the small bowel 4. ileocecal valve could not be identified brief hospital course: 58 year old female with hiv on haart, (cd4+:266 and vl undetectable ), hcv cirrhosis w/o known varices, esrd on hd ( hiv nephropathy) admitted with melena and significant hematoctrit drop s/p 2 units of prbcs . 1. gi bleed: source likely upper gi given melana and pink ng lavage. tagged rbc scan did not show active bleeding. she was given two units of prbcs overnight. she was started on iv pantoprazole 40 . her hematocrit remained stable after red blood cell transfusion. . 2. abdominal pain: ttp in ruq/rlq of unclear etiology. @ baseline. . 3. esrd on hd: on t/th/sat schedule. continued on sevelemer, nephrocaps with epogen in hd . 4. hiv: last vl undetectable, cd4+ 266 (7/). patient started on bactrim in previous admissions, however has not been taking. reportedly refused bactrim in previous admission. continued haart regimen. bactrim was held since cd4 is >200, no h/o pcp, no history of oral candidiasis which is based on cdc guidelines. she was discharged on bactrim to be further managed by her primary care/ infectious disease doctor. . 5. hepatitis c: c/b reported cirrhosis and portal hypertension (portal hypertensive gastropathy, no esophageal varices). followed by liver clinic. last viral load less than one million. not on interferon. . 6. murmur: harsh holosystolic murmur heard throughout the precordium. this should be followed up as an outpatient with an echocardiogram. . patient left ama before she was seen by attending and could receive discharge paperwork. she was aware of the risks and benefits of leaving. she was aware of her post discharge follow up appointments tomorrow. medications on admission: 1. lamivudine 50 mg daily 2. etravirine 200 mg 3. tenofovir disoproxil fumarate 300 mg one qfri 4. b complex-vitamin c-folic acid 1 mg daily 5. sevelamer hcl 800 mg po tid w/meals 6. albuterol sulfate 90 mcg/actuation 1-2 puffs inhalation q6h as needed for shortness of breath or wheezing. 7. sulfamethoxazole-trimethoprim 400-80 mg tablet sig: one (1) tablet po daily (daily). 8. omeprazole 40 mg capsule twice a day. discharge medications: 1. lamivudine 100 mg tablet sig: 0.5 tablet po daily (daily). 2. etravirine 100 mg tablet sig: two (2) tablet po bid (2 times a day). 3. tenofovir disoproxil fumarate 300 mg tablet sig: one (1) tablet po qfri (every friday). 4. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 5. sevelamer hcl 400 mg tablet sig: two (2) tablet po tid w/meals (3 times a day with meals). 6. omeprazole 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 7. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: 1-2 puffs inhalation every six (6) hours as needed for shortness of breath or wheezing. 8. bactrim 400-80 mg tablet sig: one (1) tablet po once a day. 9. outpatient lab work cbc tomorrow for hct check. discharge disposition: home discharge diagnosis: primary diagnosis 1. melena . secondary diagnosis 1. hepatitis c with cirrhosis 2. end stage renal disease on hemodialysis discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted because you were noted to have melena, weakness and significant drop in your blood volume. you were given two units of blood. upper gi endoscopy and tagged rbc study showed no active bleeding. . no medication changes were made to your regimen . patient left ama before she was seen by attending and could receive discharge paperwork. she was aware of the risks and benefits of leaving. she was aware of her post discharge follow up appointments tomorrow. followup instructions: please make an appointment with your primary care physician, . within the next two days. department: advanced vasc. care cnt when: monday at 10:00 am with: , md building: (, ma) campus: off campus best parking: free parking on site department: liver center when: monday at 11:15 am with: building: lm campus: west best parking: garage department: div. of gastroenterology when: tuesday at 3:00 pm with: , md building: ra (/ complex) campus: east best parking: main garage procedure: other endoscopy of small intestine hemodialysis diagnoses: thrombocytopenia, unspecified end stage renal disease renal dialysis status cirrhosis of liver without mention of alcohol chronic hepatitis c without mention of hepatic coma human immunodeficiency virus [hiv] disease diaphragmatic hernia without mention of obstruction or gangrene blood in stool abdominal pain, other specified site other specified disorders of stomach and duodenum unspecified gastritis and gastroduodenitis, without mention of hemorrhage undiagnosed cardiac murmurs internal hemorrhoids without mention of complication unspecified chronic bronchitis 

Answer: The patient is high likely exposed to