Chronic Hepatitis B

My dad, currently 60 yrs old, was diagnosed with Hepatitis B about 5-6years ago. In Oct 2005, his liver injury was so bad (as seen from abnormal high level of AST and ALT of 500 and above) that it affected his gall bladder (which develop into jaundice). He was admitted to hospital for 5 days, and his condition improved and over a few months, went back to normal. CT scan revealed no signs of cancer or cirrhosis but HBV DNA count was a few hundred thousands.

Now in 2007, we do blood test almost every month. And here is my question -  At Mar 07, his ALT/AST is normal, and AFP at 30, ultrasound is ok. At Apr 07, his ALT/AST went up to 57/63 level but AFP went down to 14.4, ultrasound is normal. We also did a HBV DNA count, it was > 1 million (last test done in Oct 06 also revealed similar count) . At May 07, GGT/ALT/AST all went up and is at 87/126 level, but AFP went down further to 9, ultrasound is still normal (no focal liver lesion seen). Strangely, in the last 3 weeks, my dad;s (who is also diabetic but with good control at 7 HBA1C)fasting glucose shot up to 10+ in the last 3 weeks and now only came down to 9.5.

Is the rising ALT/AST a cause for concern, while the AFP is normalised? What other tests can be done? Is a CT scan necessary when the ultrasound is ok? Any recommendation?
Lastly, my dad is only taking herbal health medicine for the liver.

[stevenNYer]

The typical test to detect liver cancer is AFP and ultrasound.  I was told either test could miss a certain percentage for cancer so doctors typically order both test since it's easy to tolerate and low cost.  AFP for some people tends to fluctuate.  CT scan normally follows something detected by sonogram.  My question is if your dad has HepB for several years, 60 yo, probably the eAntigen - chronic type with some sort of mutant strain given his high DNA, why isn't he on some kind of antiviral meds like Baraclude to minimize further liver damage by HepB virus?  Hope your dad feels better.