I made an account to reply to this thread. I am a psychology student specializing in sexuality!
So, first: yes, in most places, particularly the US, images which are indistinguishable from a real child (such as photorealism) are included as CSAM, regardless of whether or not the child “exists.” This does not include things like lolicon, cub, cartoons, every historical painting ever, etc. There is no provable harm caused by cartoon images of “sexualized minors,” as determined by the Sexological Clinic (seen here, translated from it’s original language).
That would mean that, yes, hyper-realistic imagery of children in sexual situations does, at least in the USA, count as CSAM. As a psychology student, there is also heavy push to prevent patients with pedophilic or inhibition disorders to seek out such material, as it can and does lead to harm. Once again, I am not talking about lolicon-- I am talking about CSAM.
Laws may vary in regards to UK, AU, CA, FR, etc. To my understanding, all of those countries claim to ban any such depiction, regardless of it’s level of toony-ness. They also allow works like Stephan King’s IT and Tony Morrison’s The Bluest Eye, which technically fall under their ban. CA also sells Interspecies Reviewers, known for it’s loli content, in bookstores. So, I suppose you should be "grain of salt"ing this one. Also note that as an American, I do not know the intricacies of other countries laws-- we are barely taught our own.
And, no, the PROTECT act is not in effect in the USA. It was deemed unconstitutional. I’m only providing what I can as a student with a vested interest in this kind of thing.
TL;DR
Photorealistic AI images of CSAM is still CSAM and is still bad. AI images of loli hentai are not comparable.
No notes on roleplay/text, that’s probably case-by-case (but is likely viewed more similarly to the loli thing).
Thanks! Happy to help where I can. :)