Nosocomial outbreak of multiple bloodborne viral infections

In resource-limited countries, nosocomial transmission of bloodborne pathog ens is a major public health concern. After a major outbreak of human immun odeficiency virus (HIV) infection in similar to 400 children in 1998 in Lib ya, we tested HIV, hepatitis C virus (HCV), and hepatitis B virus (HBV) mar kers in 148 children and collected epidemiological data in a subgroup of 37 children and 46 parents. HIV infection was detected in all children but on e, with HCV or HBV coinfection in 47% and 33%, respectively. Vertical trans mission was ruled out by analysis of parents' serology. The children visite d the same hospital 1-6 times; at each visit, invasive procedures with pote ntial blood transmission of virus were performed. HIV and HCV genotypic ana lyses identified a HIV monophyletic group, whereas 4 clusters of HCV sequen ces were identified. To our knowledge, this is the largest documented outbr eak of nosocomial HIV transmission.