One important limitation of this study is that these measurements were cross-sectional; we recommend longitudinal follow-up of these mechanistic pathways among ART-treated adults in SSA to better understand the causation and consequences of persistent immune activation and inflammation including understanding the role of inflammasome byproducts as well as Nef-1 protein, gasdermin-D, and latent reservoir characteristics on persistent immune activation and inflammation during long-term suppressive ART for treatment of chronic HIV infection in SSA. Here, GSDMD is linked to HIV infectious disease.