South African scientists - hailed for their discovery of Omicron - are investigating the "highly plausible hypothesis" that the emergence of new Covid-19 variants could be linked, in some cases, to mutations taking place inside infected people whose immune systems have already been weakened by other factors, including, though not limited to, untreated HIV.
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Researchers have already observed that Covid-19 can linger for many months in patients who are HIV positive but who have, for varying reasons, not been taking the medicines that would enable them to lead healthy lives.
"Normally your immune system would kick a virus out fairly quickly, if fully functional," said Professor Linda-Gayle Bekker, who heads the Desmond Tutu HIV Foundation in Cape Town.
"In someone where immunity is suppressed, then we see virus persisting. And it doesn't just sit around, it replicates. And as it replicates it undergoes potential mutations. And in somebody where immunity is suppressed that virus may be able to continue for many months - mutating as it goes," she added.
But, as they push ahead with their research, the scientists are anxious to avoid further stigmatising people living with HIV, both in South Africa - home to the world's largest HIV epidemic - and globally.
"It's important to stress that people who are on anti-retroviral medication - that does restore their immunity," Professor Bekker said.
Two cases of particular interest have now been detected in South African hospitals. One woman continued to test positive for Covid-19 for almost eight months, earlier this year, while the virus underwent more than 30 genetic shifts.
Professor Tulio de Oliveira, who leads the team that confirmed the discovery of Omicron, noted that "10 to 15" similar cases had been found in other parts of the world, including the UK.