TL
R ratings.
Art: 8. A bit generic, but not bad, and very effective.
Plot: 9ish. It's a tragedy start to finish, but it's executed extremely well, even if it is a bit predictable and formulaic.
Content: It gets gross and fucked up and horrific, it's earned the "Horror" tag multiple times over, so be very careful and tap out as soon as you feel uncomfortable about anything because IT GOES PLACES.
Personal rating: N/A. If you're into it it's a masterpiece. If you're not, it's something best left alone. Ultimately, for my cataloging purposes I'm giving it a 1, but only because this is not my cup of tea. I think it deserves a 8-10 from an objective standpoint and the author did a good job executing what he was going for, but you've gotta be into some sick shit for that to be a good thing.
Rating for people who like this stuff: Probably a 10 unless it pushes your boundaries.
Rating for people who aren't sure they like this stuff but are curious: GET OUT WHILE YOU STILL CAN, THIS IS NOT THE ONE TO START OFF WITH.
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This is the first manga I've ever had difficulty rating. On the one hand, as porn it's barely titillating unless you're into some gross ass shit. On the other hand, it has an actual plot that, while melodramatic and soap opera worthy, is solidly written and is as horrifying as I thought similar manga would get. On the one hand I want to rate it like, an 8 or 9 because boy did it hit hard and I actually just read it through for the plot, but on the other hand it's a trainwreck start to finish and I'm incredibly disgusted and never want to look at it again, so I wanna give it a low score.
In the end my recommendation is this. It has well earned the horror and drama tags, and if you're willing to tank where it goes (and BOY does it go places) it's a well executed story that'll make you feel a lot of emotions. But if you're a lightweight, or you're just looking for something to breeze through while you get off,
find something else because while the art's solid, everything surrounding it makes it disgusting (unless you're into that sort of thing, then this is like, a 10/10, but also you're a sicko).
(If he puts out another story that's much more vanilla I'll definitely read it though.)