Libya's Supreme Court on Wednesday upheld the death sentences of five Bulgarian nurses and a Palestinian doctor convicted of infecting more than 400 children with the AIDS virus. But the verdict may not be the final word in the case.

Libya's Supreme Judicial Council, which is headed by the minister of justice, could approve or reject the convictions or set lighter sentences. Libya's foreign minister said the council would convene on Monday.

Libya has been under intense international pressure to free the six, who deny infecting the children. The case has become a sticking point in Libya's attempts to rebuild ties with the United States and Europe. President Bush called on Libya last month to free the medics.

"The court has accepted the appeal in principal but rejects its content, therefore the court decided to uphold the verdict against them," Judge Fathi Dahan told the courtroom. The five nurses and the Palestinian doctor were not present in the court for the appeal hearing.

About 20 relatives of children who were infected with HIV rejoiced at the court's ruling and chanted: "Long live justice!"

"This is a victory for the Libyan judiciary system. We are awaiting the execution of the death sentence," said the families' lawyer Al-Monseif Khalifa.

In announcing the verdict, the judge mentioned nothing about a settlement announced Tuesday by a foundation headed by the Libyan leader's son.

The Gadhafi International Foundation for Charity Associations said Tuesday that the families of the HIV-infected children reached an agreement with the nurses and doctor but would not say whether the deal involved financial compensation for the families.

On Tuesday in Tripoli, Idris Lagha, head of the Association for the Families of the HIV-Infected Children, said that a deal would be announced in a couple of days. Lagha did not provide more details.

Libya's ambassador to Britain, Mohammed al-Zaway, has said in the past that an agreement with the families would reflect positively on the case according to Islamic law. Often referred to as "blood money," compensation for death or suffering is a legal provision in the traditional Islamic code that is widespread in parts of the Middle East and North Africa.

European leaders on Wednesday expressed disappointment at the court's ruling but said they remained hopeful that the case would be resolved.

"We regret that these decisions have been taken, but I'd also like to express my confidence that a solution will be found," European Commission President Jose Manuel Barroso said in Strasbourg, France.

Bulgaria's chief prosecutor Boris Velchev also voiced hope Wednesday that politicians will achieve what the Libyan court has not — a pardon of the Bulgarian nurses in Libya and their return to Bulgaria.

"The case is now entirely in the hands of politicians," Velchev said.

Vladimir Chukov, a history professor and expert on Middle East affairs in Bulgaria's capital, Sofia, said the court's decision satisfies the relatives of the children and Libyan public opinion.

"But, ironically, it could be positive for the medics as well, because it marks the end of the yearlong judicial procedures. Their case is moving now on a political level and we hope that through negotiations it will end with their release," he said.

The six began working at the hospital in the city of Benghazi in 1998 and were arrested the next year after more than 400 children there contracted HIV. Fifty of the children have died.

The prosecution insists that the six infected the children intentionally in experiments to find a cure for AIDS. Defense experts testified that the children were infected by unhygienic hospital conditions. In their testimony, the workers said the confessions used by the prosecution had been extracted under torture. Several of the nurses have said they were also raped to force confessions.

The medical workers, who have been in custody since 1999, were convicted and sentenced to death in 2004, but the Supreme Court ordered a retrial after an international outcry over the verdicts.

In a ruling that shocked many in Europe, the second trial ended with the same verdict in December despite a scientific report weeks earlier saying HIV was rampant in the hospital before the six began working there.

Two Libyans — a police officer and a doctor — were put on trial on charges of torturing them and were later acquitted — which led to the six medics being put on a new trial for defamation. They were acquitted of defamation in May.

The Gadhafi International Foundation for Charity Associations, which announced the settlement Tuesday, is headed by Seif al Islam, son of longtime Libyan leader Moammar Gadhafi. He has been active for months in trying to resolve the case of the medics.

Gadhafi had tried in the past to reach a deal by which Bulgaria would compensate the victims. But the Bulgarian government had rejected the proposal, saying it would imply the nurses' guilt.