I think RPKI is good enough. As we have TLS on top it doesn't need to be perfect.
For LetsEncrypt, routing is authentication: if packets routed to the IP in the A record end up at your place, you can get a cert for that domain.
Those two things address orthogonal issues
Only with certificate pinning or something similar. Otherwise, the attacker can get valid TLS certificates for any domain hosted on the hijacked IP addresses.