Stateful cloud workloads require high-performance persistent storage when running on untrusted cloud infrastructure. Confidential Virtual Machines (CVMs) promise to protect these workloads through hardware-enforced memory encryption and isolation without requiring application changes. However, they protect only data in use; persistent storage lies outside the CVM trust boundary, exposing all stateful data to the cloud provider. Extending the trust boundary to persistent storage presents inherent challenges. High-bandwidth workloads require near-raw NVMe throughput, yet the default kernel CVM I/O stacks are inadequate, and userspace I/O libraries are not designed with CVM use cases in mind. Access patterns and storage semantics vary between workloads, necessitating access-pattern-aware security abstractions rather than uniform block-level encryption. In order to mitigate against rollback, freshness is needed, but CVMs lack hardware primitives for this purpose, requiring alternative solutions. We present CVM-Store, a storage system that co-designs a high-throughput userspace I/O engine with CIF (confidentiality, integrity, freshness) data protection. The key insight is that neither authenticated encryption nor I/O is a bottleneck by itself, but their naive combination is. CVM-Store exploits this by interleaving them, eliminating redundant copies and OS/hypervisor mediation. CIF guarantees are provided as composable primitives that adapt protection to workload access patterns, from which we derive three concrete authenticated abstractions: a KVS, a log, and a filesystem. An asynchronous trusted counter service provides freshness guarantees with epoch-based batching, which enables rollback protection without dedicated hardware support. CVM-Store delivers full CIF guarantees within $\approx$1% (write) and 1-19% (read) of raw NVMe bandwidth for large objects.

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