In 1998, outbreaks of human immunodeficiency virus type 1 (HIV-1) and hepatitis C virus (HCV) infection were reported in children attending Al-Fateh Hospital in Benghazi, Libya. Here we use molecular phylogenetic techniques to analyse new virus sequences from these outbreaks. We find that the HIV-1 and HCV strains were already circulating and prevalent in this hospital and its environs before the arrival in March 1998 of the foreign medical staff (five Bulgarian nurses and a Palestinian doctor) who stand accused of transmitting the HIV strain to the children.

1. Department of Zoology, University of Oxford, Oxford OX1 3PS, UK
2. Institute of Evolutionary Biology, University of Edinburgh, Edinburgh EH9 3JT, UK
3. College of Medicine, University of Florida, Gainesville, Florida 32610, USA
4. Faculty of Health Sciences, University of Pretoria, 0001, Pretoria, South Africa
5. Department of Infectious Diseases, Istituto Superiore di Sanitá, 00161 Rome, Italy
6. Department of Immunology and Infectious Diseases, Bambino Gesú Children's Hospital, 00165 Rome, Italy
7. Spallanzani Institute for Infectious Diseases, 00149 Rome, Italy
8. Department of Internal Medicine, University of Rome "Tor Vergata", 00133 Rome, Italy
9. Geneva University Hospital, 1211, Geneva, Switzerland
10. Department of Biology, University of Rome "Tor Vergata", 00133 Rome, Italy
11. Department of Experimental Medicine and Biochemical Sciences, University of Rome "Tor Vergata", 00173 Rome, Italy
12. For full listing, see supplementary information.

Correspondence to: Tulio de Oliveira¹ Email: tulio.deoliveira@zoo.ox.ac.uk

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