I am having the same kind of bugs with the serial killer perk. It went up by 2 , then back down by 2 after two kills. Then it seemed to be working for about 6 kills in a row, I saved ,re-loaded the save file, and it reset my max health back to the starting point as if I had not made those kills. Obsidian please fix this bug. I made an account just to request this bug fix.