We identified seven trials, with 895 evaluable participants for this review . All provided data suitable for the primary outcome meta-analysis . One of the trials was new since the last version of this Cochrane systematic review . Risk of bias in the older, smaller studies included some unclear- or high- risk assessments, whereas we deemed the larger studies at low risk of bias . Overall, 79/452 (17%) participants allocated to corticosteroids had incomplete recovery of facial motor function six months or more after randomisation ; significantly fewer than the 125/447 (28%) in the control group ( risk ratio ( RR ) , 95% confidence interval ( CI ) to , seven trials, n = 895). The number of people who need to be treated with corticosteroids to avoid one incomplete recovery was 10 (95% CI 6 to 20). The reduction in the proportion of participants with cosmetically disabling sequelae six months after randomisation was very similar in the corticosteroid and placebo groups ( RR , 95% CI to , two trials, n = 75, low-quality evidence). However, there was a significant reduction in motor synkinesis during follow-up in participants receiving corticosteroids ( RR , 95% CI to , three trials, n = 485, moderate-quality evidence). Three studies explicitly recorded the absence of adverse effects attributable to corticosteroids. One trial reported that three participants receiving prednisolone had temporary sleep disturbances and two trials gave a detailed account of adverse effects occurring in 93 participants, all non-serious; the combined analysis of data from these three trials found no significant difference in adverse effect rates between people receiving corticosteroids and people receiving placebo ( RR , 95% CI to , n = 715).
So CD4 counts appear to be a useful tool in assessing risk, but other factors also contribute such as lung architecture. In a retrospective study of 74 patients with interstitial lung disease on corticosteroids, 7 patients developed PCP. The mean dose at time of diagnosis was prednisone 37mg with mean duration of 10 weeks. CD4 counts ranged from 59 to 836, with a mean of 370 . The authors argued that due to their underlying lung disease, the patients were at higher risk for PCP and became infected at higher CD4 counts than patients with other underlying diseases.