The five Bulgarian nurses and Palestinian doctor were not in court for the verdict, announced the day after a compensation deal was reached with the children's families that could see the death sentences commuted to prison terms.

"In the name of the people, the court has decided not to accept the defendants' appeal and confirms the death penalty against them," chief judge Fathi Dahan said.

Libya's top legal body is due to meet next week to examine the compensation deal negotiated by the Kadhafi Foundation, a charitable body headed by the son of Libyan leader Moamer Kadhafi.

"The Supreme Judicial Council is going to meet on Monday and it will be up to this body to cancel or commute the verdict pronounced today by the supreme court," foreign minister Abdel Rahman Shalgham told reporters.

Nurses Snezhana Dimitrova, Nasya Nenova, Valya Cherveniashka, Valentina Siropulo and Kristiana Valcheva and Palestinian doctor Ashraf Juma Hajuj -- who now has Bulgarian nationality -- have been behind bars since February 1999 but have always protested their innocence.

They were convicted of infecting 438 children with HIV-tainted blood at a hospital in the Mediterranean city of Benghazi and sentenced to death in May 2004. Fifty-six of the children have since died.

But foreign health experts have cited poor hygiene as the probable cause of the epidemic in Benghazi, Libya's second city.

Bulgaria's Deputy Foreign Minister Feim Chaushev said Sofia was pursuing talks with Tripoli despite the rejection of their final appeal.

"From now on everything is in the hands of Libya's Supreme Judicial Council. Our efforts continue and we continue talks with the Libyan side for finding a positive solution to the case," Chaushev told Inforadio.

Bulgarian lawyers for the nurses condemned the verdict.

"I am devastated. Justice was not done," lawyer Hari Haralambiev told Bulgarian national radio by telephone from Tripoli.

"Libyan justice wrote a sad and shameful page in its book. It is obvious now that Libyan justice was exploited for reaching other goals," the Bulgarian coordinator of the defence Trayan Markovski added.

Salah Abdessalem, director of the Kadhafi Foundation run by Kadhafi's son Seif al-Islam had said on Tuesday that a compromise acceptable to the children's families had been reached.

"This accord satisfied all the parties and puts an end to this crisis," he said, adding that the deal was between the families and a special aid fund for victims set up by Tripoli and Sofia in 2005 under EU auspices.

The Supreme Court had deferred its judgment at an initial hearing on June 20, when the prosecution sought confirmation of the death sentences against the six, who say their confessions were extracted by torture.

A representative of the victims' families has said the compromise deal would see the death penalty commuted to jail terms, which could be served in the medics' country of origin, as Libya and Bulgaria have an extradition treaty.

US President George W. Bush had urged Kadhafi in a letter delivered on Monday to help in the dispute, telling him that the case and lingering issues tied to the 1989 Lockerbie bombing needed his attention.

The six medics still face defamation charges brought by a senior police officer after being acquitted in May on similar charges.

The cases arise from claims that the medics "confessions" in the AIDS trial were forced from them under torture, including beatings, electric shocks and being threatened with dogs.

If found guilty in the new trial, brought by Salim Jomaa Salim, head of the police dog unit, they face sentences of up to three years in jail.