Introduction: Children are infected with Human Immunodeficiency Virus mostly through vertical transmission. In vast majority of cases, their father and mother both are HIV positive and sooner or later these children become orphan. Though, there is significant decrease in new cases of HIV, both in children as well as in adults, but the number of orphan children is increasing. These children are exposed to variety of adversities which affects their health and survival. To study the health status of HIV infected orphan children and how does it differ from their non orphaned counterparts, this study was undertaken. Methods: This is an hospital based observational study, in which HIV positive children diagnosed as per NACO HIV testing guidelines, between age 18 months to 15 years were included. Their orphan status was decided by history given by their caregivers/ guardians. Thorough clinical examination and required investigations of both, orphan and non orphan HIV positive children was done and their health status, morbidity and mortality were assessed. Result: Out of 140 children, 47 were orphan and 93 non orphan. Mean age of double orphan children was 11.6 0 (SD±1.42) years and single orphan children was 9.13 (SD±2.66) years. Grandparents, aunts and maternal uncle were the care givers of these orphan children. Severe anaemia and severe under nutrition was more common in orphan children than in non orphan. In 27.66% orphan children severe immune suppression was noted as compared to 12.90 % in non orphan children. Recurrent serious opportunistic infections were more common in orphan children than in non orphan. Out of six deaths, five children were orphan. No significant difference was noted in socio economic distribution, treatment adherence and follow up.

Keywords: Health Status; HIV Infection; Orphan Children.