Introduction: Cellular and humoral response are required for the SARS-CoV-2 eradication. Antigen presenting cells load SARS-CoV-2 peptides on human leukocyte antigen with different avidity and present to T and B cells for the differential humoral and cellular response. Due to immunosuppression, renal transplant recipient patients are speculated to poorly form the antibody against SARS-CoV-2 virus. Therefore, determining the association of specific HLA alleles with anti-SARS-CoV-2 spike protein antibody formation will be helpful in managing the renal transplant recipient patients having specific HLA alleles from SARS-CoV-2 infection and vaccination.

Material and Methods: In this study anti-SARS-CoV-2 spike protein antibody in 161 renal allograft recipient patients were determined by the chemiluminescent microparticle immunoassay methods and human leukocyte antigen alleles were determined by the polymerase chain reaction-single strand oligonucleotide methods and analyzed to study, the HLA alleles association with anti-SARS-CoV-2 spike protein humoral response and severity of COVID-19 symptoms in recently SARS-CoV-2 infected patients. Seroconversion was defined if anti-SARS-CoV-2 spike protein antibody titer was >50AU/ml.

Results: The anti-SARS-CoV-2 spike protein antibody seroconversion rate in renal allograft recipients was 90.06% with median titer 751.80 AU/ml. The frequency of HLA class I alleles A*11 was in 22.1%, A*24 in 21.37%, A*33 in 20.68%, HLA B*15 in 11%, B*07 in 8.27%, HLA-C*30 in 20.93% and C*70 in 23.25% and Class II HLA alleles -DRB1*07 was in 18.62%, DRB1*04 in 13.8%, HLA-DRB1*10 in 14.48% and HLA-DQA1*50 in 32.55% of patient and were associated with the seroconversion.

HLA-B*04, B*52, and B*55 were associated with non-seroconversion in 18.75%, 12.5 and 6.25% of patients respectively, HLA- C*07, C*12, C*30 in 16.6% of patients and C*60 in 33.3% of patients were associated with non-seroconversion. HLA-DRB1*01, HLA-DRB1*03 in 12.5% and DRB1*70 in 6.25% of patients were associated with non- seroconversion. The mean post-infection time of patients recovery from COVID19 symptoms was 18.25±8.14 days.

Conclusion: Renal transplant recipients with SARS-CoV-2 infection developed a robust seroconversion rate of 90.0% and different alleles of HLA-B, DRB1 and DQA1 were significantly associated with the seroconversion.