Truth.
Since I haven't been in game for that long, and haven't been able to interact with more than just a handful of characters, I still have so much exploring to do with Pestilence as a character. SO THIS WILL BE BRIEF. The main issue with Pestilence is, I think, how she's initially so very uninterested in others unless there's just that something about them that she finds curious or interesting. I think she misses out on a lot of stuff because of that in 'real life', or you know, the life that happens outside of the game for her.
The way she puts the other Horsemen before anything is also a bit of an issue; no matter how much she likes you, if she has to choose between you and a Horseman, she doesn't even need to stop and consider her choice. Within that dynamic, she's already liking Famine more than the others (but just marginally so) and is somewhat worried about it. She worries it will become an issue later and thus tries to treat him as she treats the other two.
More to be added when she gets to interact more with others, I swear.